decisionhealth Newsletters, Part B News - 2015 Issue 4 (April)
With SGR repealed, payment predictability, value-based fees settle in for practices
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Article Overview
This article is for physicians, practice managers, and medical billing professionals tracking Medicare payment policy. It reviews the shift from SGR-related uncertainty to a more predictable Medicare physician payment schedule, discusses the move toward value-based payment models, and summarizes the consolidation of major quality reporting programs under MIPS. The piece also notes how CMS handled affected claims and frames the policy changes in terms of practice planning and participation in alternative payment models.
Why This Topic Matters
The article covers major Medicare payment policy changes that can affect revenue planning, quality reporting, and participation in alternative payment models. Understanding the new payment structure and reporting framework helps practices prepare for changes in reimbursement and compliance requirements.
Article Sections
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Payment picture: Past, present, future
Provides background on the Medicare payment policy shift and the broader direction of physician payment changes over time. It also addresses the transition from prior payment uncertainty to a more predictable framework.
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Value-based payment binge
Discusses the growing emphasis on value-based payment models and the general types of incentives associated with participation. It also explains the article’s broader focus on alternative payment approaches in Medicare.
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Reporting program round-up
Summarizes the consolidation of physician quality reporting and related programs into a single reporting structure. It also covers the article’s discussion of ongoing reporting expectations and the implementation timeline.
What You Will Learn
- How Medicare physician payment policy changes are presented in the article
- How the article frames the shift toward value-based payment models
- Which reporting programs are being consolidated into a single system
- What the article says about timing and transition issues for practices
Who Should Read This
- Physicians
- Medical practice administrators
- Medical billers and coders
- Revenue cycle staff
- Healthcare consultants
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