decisionhealth Newsletters, Part B News - 2020 Issue 1 (January)
Single payer will stall, E/M changes will stay on track, ransomware will proliferate
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Article Overview
This article summarizes 2020 predictions affecting physician practices, including federal health reform, E/M documentation and payment updates, cyber risk trends, Medicare policy, drug pricing efforts, prior authorization technology, telehealth growth, and emerging coding attention around vaping-related conditions. It is aimed at physicians, practice managers, coders, compliance teams, and health care policy professionals who need a broad view of likely regulatory and operational developments.
Why This Topic Matters
It helps readers understand which policy and operational issues were expected to shape practice administration, reimbursement, security, and coding workflows in 2020.
Article Sections
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2020 predictions
An overview of the article’s forecast format and the major health care topics covered across the year ahead.
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Federal health reform and court challenges
Discussion of stalled federal reform efforts, litigation affecting major coverage policy, and the political environment shaping those debates.
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E/M office visit documentation and payment changes
Coverage of planned evaluation and management documentation updates and the anticipated budget and reimbursement implications for physician practices.
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Cybersecurity threats in health care
A forecast of continued cyberattacks and security risks affecting providers, facilities, and electronic records environments.
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Medicare for All and related coverage proposals
A look at competing Democratic health coverage ideas and other legislative alternatives being discussed in Congress.
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Obamacare’s biggest judicial challenge
Summary of the major legal challenge to the Affordable Care Act and the court history surrounding it.
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Medicare Advantage growth and enforcement
Projection of continued growth in Medicare Advantage along with heightened compliance attention tied to risk adjustment practices.
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Drug pricing reform efforts
A review of administration and congressional drug pricing initiatives and the barriers facing them.
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Non-physician practitioner utilization
Discussion of the expanding role of non-physician clinicians in practice settings and care delivery.
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Prior authorization technology
Coverage of emerging technology tools intended to reduce administrative friction in authorization workflows.
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Telehealth initiatives
A forecast of continued expansion in telemedicine adoption and related service models.
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Electronic cigarette abuse coding
Discussion of coding and public health attention surrounding vaping-related conditions and related CMS activity.
What You Will Learn
- Which broad policy and reimbursement topics were expected to influence physician practices in 2020
- How federal health reform, court cases, and Democratic health proposals were framed in the article
- What kinds of documentation, payment, and compliance changes were being watched for evaluation and management services
- Why cybersecurity and ransomware were considered major operational concerns for health care organizations
- What market and administrative trends were expected to affect Medicare Advantage, prior authorization, telehealth, and non-physician practitioner use
Who Should Read This
- Physician practices
- Medical coders
- Billing and reimbursement staff
- Practice managers
- Compliance professionals
- Health care attorneys
- Health policy analysts
- Health IT and security teams
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