Medicare Compliance & Reimbursement - 2015 Issue 6
Medicare Pay: Usher Out SGR Formula - For Good
Subscribe or sign in to view the full article.
Article Overview
This article is a policy overview for physicians, surgeons, coders, and practice administrators who need to understand how MACRA changes Medicare payment direction and what related federal provisions may affect reimbursement and compliance. It covers the shift from SGR to a new quality-focused payment framework, the consolidation of existing reporting and incentive programs, and several additional Medicare and health program provisions that influence timing, funding, and administrative requirements.
Why This Topic Matters
The article matters because it summarizes a major change in how Medicare physician payment is structured and highlights several other federal provisions that can affect practice planning, reimbursement expectations, and operational readiness.
Article Sections
-
Expect new quality pay plan(s)
Introduces the shift from the prior Medicare payment approach to a new quality-based framework. It also discusses the overall direction of payment updates and the broader move away from temporary fixes.
-
Expect Pay Initial Pay Boost, New Model
Describes the initial Medicare payment updates under MACRA and the transition to a new incentive structure. It outlines the consolidation of existing quality and reporting programs and the role of alternate payment models.
-
Prepare for Other Changes
Summarizes additional MACRA provisions that may affect practices beyond payment reform. Topics include coding implementation timing, premium-related funding changes, geographic payment adjustments, CHIP funding, inpatient status policy, and surgical payment-related reporting changes.
What You Will Learn
- How MACRA changes the overall Medicare physician payment framework
- Which existing quality and reporting programs are being consolidated
- What broader Medicare and health policy provisions are included alongside the payment changes
- Which practice-operations issues are discussed in connection with the legislation
Who Should Read This
- Physicians
- Surgeons
- Medical coders
- Billing staff
- Practice administrators
- Revenue cycle professionals
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com