decisionhealth Newsletters, Part B News - 2023 Issue 12 (December)
Physician regulatory burden persists; likelihood of relief spotty
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Article Overview
This article summarizes a survey of health care executives about the most burdensome regulatory issues affecting physician practices and examines current and pending policy developments that may change the landscape. It is relevant to physicians, administrators, compliance staff, and coding/billing professionals who track Medicare, payer utilization management, interoperability, and payment program requirements.
Why This Topic Matters
The piece highlights how administrative and payment-system pressures continue to affect practice operations, reimbursement, and patient access, while outlining the direction of federal rulemaking and legislation that could alter those burdens.
Article Sections
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Survey findings on regulatory burden
Summarizes the major administrative and payer-related burdens identified by health care executives in the survey. It also places the current findings in context with prior survey results.
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Prior authorization reform and policy outlook
Covers recent and pending federal activity related to prior authorization and related data-exchange requirements. It discusses broad developments involving Medicare Advantage, interoperability, and payer process changes.
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QPP/MIPS losing appeal
Reviews survey sentiment and policy issues surrounding the Quality Payment Program and its physician participation trends. It also discusses broader concerns about alternative payment models and CMS efforts within the program structure.
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Say it in dollars
Addresses concerns about physician reimbursement trends and budget-related policy constraints. It notes legislative ideas tied to payment updates and the broader congressional environment.
What You Will Learn
- Which categories of regulation and payer administration are causing the most concern for physician practices
- What federal policy developments are influencing prior authorization and data exchange
- How survey respondents view the Quality Payment Program and alternative payment model direction
- Why reimbursement and budget policy remain central to practice dissatisfaction
Who Should Read This
- Physicians
- Medical practice administrators
- Billing and compliance professionals
- Health care executives
- Revenue cycle teams
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