PBN’s 2017 predictions: Right on QPP, CCM, fraud — and almost everything else

Why This Topic Matters

It offers a practical year-in-review for organizations that follow Medicare policy and health care operations, showing which broad trends accelerated, stalled, or drew regulatory attention. The article helps coding, compliance, and practice management audiences understand how major programs and enforcement priorities were shaping the environment.

Article Sections

1. Overview

   The article introduces a retrospective look at a set of 2017 predictions and frames the discussion around broad trends in health care policy and operations.

2. Affordable Care Act and patient payment trends

   This section discusses coverage changes, patient cost exposure, and how payment patterns may have shifted in response to policy uncertainty.

3. MACRA and the Quality Payment Program

   This section reviews federal physician payment reform and the Quality Payment Program, including the broader direction of CMS implementation.

4. MIPS participation and advancing care information

   This section addresses provider participation in performance reporting and highlights one category of the payment program that was watched closely.

5. Chronic care management services

   This section covers utilization trends for chronic care management and the overall level of uptake among Medicare practices.

6. Behavioral health integration

   This section looks at behavioral health integration services and related care coordination initiatives introduced during the year.

7. ICD-10

   This section considers how the diagnosis coding system continued to function after prior implementation concerns had largely faded.

8. Practice consolidation

   This section summarizes merger, acquisition, and private equity activity affecting physician practices and related health care businesses.

9. Cybersecurity

   This section focuses on health care cyberattacks, organizational security concerns, and federal and industry guidance on safeguarding systems and data.

10. False claims and fraud enforcement

    This section reviews federal fraud enforcement activity and the scale of government action during the year.

11. ACA repeal prediction

    This section closes with a reader prediction about the Affordable Care Act and the article’s retrospective assessment of that forecast.