decisionhealth Newsletters, Part B News - 1999 Issue 7 (July)
HCFA hires contractor to help evaluate practice expense data
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Article Overview
This article explains HCFA’s decision to bring in a contractor to evaluate and improve the process used to refine practice expense relative value units. It is relevant to medical coders, physician practices, specialty societies, and reimbursement professionals who track Medicare fee schedule policy, practice expense data sources, and advisory review processes. The piece discusses broad categories of methodology review, data validation, cost allocation, and the role of specialty group input without providing the underlying premium analysis.
Why This Topic Matters
Practice expense methodology affects Medicare payment policy across many specialties, so changes in data collection, validation, and review processes can influence reimbursement and coding-related planning.
Article Sections
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HCFA hires contractor to help evaluate practice expense data
Introduces HCFA’s contractor-assisted review of practice expense refinement and the general areas the evaluation will cover. It sets out the policy context involving specialty organizations and physician fee schedule development.
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Evaluation topics and data sources
Summarizes the broad categories of data, methodologies, and cost components under review. It also notes attention to specialty and subspecialty input as part of the assessment.
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Industry reaction and related policy issues
Describes reactions from health care observers and professional groups, along with the broader policy environment surrounding practice expense review. It references pending disputes and concerns about how the process is being managed.
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Role of advisory recommendations in future refinements
Explains how HCFA plans to incorporate advisory committee recommendations into the refinement process. It emphasizes the procedural role of specialty society review in future changes to practice expense inputs.
What You Will Learn
- How HCFA is structuring its practice expense refinement review
- What categories of data and methodology are being examined
- How specialty organization input fits into the review process
- Why practice expense policy changes matter for physician payment planning
Who Should Read This
- Medical coders
- Reimbursement specialists
- Physician practice administrators
- Specialty society staff
- Health policy analysts
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