PBN’s 2019 predictions: Hit on M&A and MIPS, missed on E/M codes, Obamacare

Why This Topic Matters

It provides a concise snapshot of which major payment, access, and documentation trends were moving in 2019 and how those trends affected physician practices, health systems, and coding teams. Readers can use it to understand the broader environment around Medicare reporting, utilization, and administrative burden.

Article Sections

1. 2019 predictions

   An overview of the year-end prediction review and the major billing, payment, and market topics being revisited.

2. Chronic care management services

   Discussion of chronic care management growth, related Medicare service activity, and factors influencing adoption.

3. Remote internet, phone and device service and consultation codes

   Coverage of emerging remote service and consultation usage trends, including survey-based adoption signals.

4. Affordable Care Act coverage trends

   A review of insurance coverage trends and how broader health policy changes were affecting patient coverage patterns.

5. Medicare Advantage growth

   A summary of enrollment growth in Medicare Advantage and its significance for practices and beneficiaries.

6. Prior authorization burden

   Discussion of administrative burden associated with prior authorization and survey findings from medical practices.

7. Health care mergers and acquisitions

   An update on merger and acquisition activity in health care, including transaction volume and market activity.

8. MIPS success rates

   A look at Merit-based Incentive Payment System performance trends and provider confidence in future scoring.

9. E/M documentation revisions

   Coverage of evaluation and management documentation changes and their anticipated impact on coding and workflow.

10. CMS and E/M coding structure changes

    Discussion of proposed and finalized changes to the evaluation and management code structure and related timing.