Eyeing the future: E/M will disrupt, the PHE will end, telehealth will stay

Why This Topic Matters

It helps readers understand which policy and reimbursement changes may affect operations, documentation, compliance, and payment in the coming year, especially around office visit coding and telehealth access.

Article Sections

1. 2021 predictions

   An overview of the year-ahead themes affecting medical practices, with discussion of policy, payment, and operational trends.

2. Prediction: The E/M guideline revisions for office visit codes will sow confusion — with the use of time and with the “complexity of data” portion of medical decision-making (MDM).

   Discussion of upcoming office visit documentation changes, practice readiness, and potential workflow and payer implications.

3. Prediction: The public health emergency (PHE) will end in 2021.

   Coverage of expected changes tied to the end of the emergency period, including vaccine rollout, Medicare flexibility, and continued policy adjustments.

4. Prediction: Congress will finally loosen up on telehealth.

   A look at telehealth’s future, including legislative prospects, payer adoption, and related Medicare communication and monitoring services.

5. Prediction: All E/M codes will get revised in 2021.

   Forward-looking commentary on broader E/M code family changes beyond office visits and the expected timing of future updates.

6. Prediction: Value-based models — including the Trump ones — will thrive under Biden.

   Discussion of value-based care, bundled payment initiatives, and direct contracting models under the new administration.

7. Prediction: Medicare for all is off the table — for now.

   Analysis of the political outlook for broader coverage expansion proposals and related federal health policy priorities.

8. Prediction: Biden will patiently, and successfully, build Obamacare back up.

   Coverage of likely administrative and regulatory actions affecting the Affordable Care Act and exchange-related policies.

9. Prediction: Expect more attention to fraud in Medicare Advantage and risk adjustment.

   Discussion of audit and enforcement trends in Medicare Advantage, including risk adjustment scrutiny and oversight activity.

10. Prediction: Ransomware threat, and losses, will continue to grow.

    A brief look at cybersecurity risks facing health care organizations and the need for stronger defenses and awareness.