Online exclusive: 3 more PBN predictions for 2023

Why This Topic Matters

The article highlights policy shifts that could affect documentation workflows, payer reporting, reimbursement risk, and how health systems capture structured patient information. It is useful for organizations preparing for Medicare payment and compliance changes tied to health equity and coverage policy.

Article Sections

1. 2023 predictions

   An overview of the article’s three forecasted policy areas and the broad operational impact they may have on providers and billing teams.

2. Prediction: Social determinants of health will become most providers’ entry to health equity in 2023.

   Discussion of health equity initiatives, SDOH data collection, and how CMS, ONC, and payer trends may influence provider workflows and interoperability efforts.

3. Prediction: Medicare’s split/shared policy will prompt cautious documentation and billing.

   Coverage of Medicare split/shared billing concerns, documentation uncertainty, and the likelihood that practices will adjust billing workflows accordingly.

4. Prediction: MACs will continue to cooperate on local coverage determinations (LCD).

   A look at contractor collaboration on local coverage policy and the role of advisory committee meetings in signaling potential uniform coverage approaches.

5. Resource

   A reference link provided at the end of the article.