E/M Coding Alert - 2016 Issue 27
Part B Payment: CMS Continues to Shift Toward MACRA's QPP with Focus on Cardiac Care
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Article Overview
This article covers proposed Medicare payment changes from CMS that are centered on cardiac care and bundled payment models, with discussion of how the proposals relate to MACRA and the Quality Payment Program. It is relevant to providers, hospitals, and coding or reimbursement professionals following federal payment policy, alternative payment models, and CMS innovation initiatives. The article also references related CMS and AMA commentary and situates the proposal within broader efforts to reward coordinated, higher-quality care.
Why This Topic Matters
The article explains a policy shift that could affect how cardiac-related care is reimbursed and how providers participate in Medicare payment reform initiatives. It matters to organizations tracking CMS rulemaking, MACRA implementation, and payment models tied to quality and coordinated care.
Article Sections
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Introduction
Introduces the CMS payment proposal and frames it within broader Medicare efforts to emphasize quality, coordination, and value-based care.
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Background
Provides context for the proposal by discussing the burden of heart disease, Medicare spending, and the need for coordinated care models.
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Three Parts Make Up the New Rule
Summarizes the main components of the proposed rule and describes the timing and scope of the affected payment models.
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AMA Chimes In
Presents the American Medical Association’s response and ties the proposal to MACRA and alternative payment model participation.
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Resources
Lists external CMS, CMS Innovation Center, and HHS references for readers seeking more information about the proposal and related initiatives.
What You Will Learn
- How CMS is framing bundled payment proposals for cardiac care
- How the proposal relates to MACRA and the Quality Payment Program
- Which organizations and initiatives are mentioned in connection with the rulemaking
- The broader policy context for value-based reimbursement in Medicare
Who Should Read This
- Medical coders
- Reimbursement specialists
- Revenue cycle staff
- Physicians
- Hospital administrators
- Health policy professionals
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