E/M doc changes, ‘remote’ consult services will grow slowly in 2019

Why This Topic Matters

The article helps practices anticipate where coding, documentation, payment, and administrative workload may shift during the year. It is especially relevant for organizations tracking Medicare policy changes, value-based payment programs, and service-line growth opportunities.

Article Sections

1. 2019 predictions

   An overview of the survey-based forecast format and the major practice-impact topics covered in the article.

2. The E/M documentation revisions will have little meaningful impact

   Discussion of expected adoption of office visit documentation updates and why many practices may not change their workflows.

3. Chronic care management (CCM) services will surpass 5 million claims

   A look at growth in chronic care management activity, payment trends, and anticipated interest in additional management services.

4. Medicare’s new remote internet, phone and device service and consultation codes won’t take off at first but will find adopters and grow steadily

   Coverage of newer remote patient monitoring and consultation-related services, including expected adoption barriers and growth factors.

5. Disruptions in the Affordable Care Act (ACA) probably won’t mean fewer insured patients in 2019 — but their insurance may cover less

   General discussion of ACA-related uncertainty, insurance-market changes, and potential downstream effects on coverage and enrollment.

6. Spurred by new benefits, practices will see more Medicare Advantage patients in 2019

   Forecasting Medicare Advantage enrollment growth, benefit changes, and likely practice implications tied to payer mix and coding needs.

7. Prior-authorization pain will persist in 2019

   A review of administrative burden related to authorizations and why practices expect little relief in the near term.

8. CMS will announce a three-code E/M series

   Coverage of anticipated E/M code-structure changes and broader stakeholder activity around future payment and documentation policy.

9. Your Merit-based Incentive Payment System (MIPS) success rates will fall in 2019

   An assessment of expected MIPS performance pressures, including category changes and increasing scoring difficulty.

10. 2019 will be another banner year for health care mergers and acquisitions

    A high-level look at consolidation trends in health care, with attention to market conditions and active service areas.