Dec 3, 2021 | Managed Care Friday
75: The percent in our Poll of the Week who believe a virtual visit for someone with substance use disorder is less effective than in-person treatment even though there are examples of companies like Eleanor Health able to use telehealth without worrying about whether it’s a billable visit given they are paid differently to manage a patient from addiction through recovery. They use the telehealth encounter as a way to check-in, to do anxiety and craving scales, and stay in front of patients as part of a goal toward recovery. A recent study published in AMA’s journal Psychiatric Times...
Nov 23, 2021 | Physician Fee Schedule, Physicians
Gastroenterology: Medicare FFS reimbursement for gastroenterology has been increasing in recent years due to E&M changes. Gastroenterology has had multiple oversight reports in recent years and a few codes have been nominated for review under the potentially misvalued code initiative. Click to read more.
Nov 23, 2021 | Physician Fee Schedule, Uncategorized
OB/GYN: Medicare FFS reimbursement for OB/GYN has been increasing in recent years due to E&M changes. There has been some program integrity developments around the specialty and Biden's Build Back Better package aims to increase Medicaid and CHIP postpartum coverage. Click to read more.
Nov 19, 2021 | Managed Care Friday
Are You Walkin’ On Sunshine? If there’s a medical specialty that can claim this Katrina and the Waves hit, it’s probably the derms – skin cancer incidence is rising faster than an Olivia Rodrigo song on the charts and there aren’t enough dermatologists. Wait times are sometimes 3-4 months and, increasingly, it’s for the PA or NP not the dermatologist. The tele-derm experiment is a potential solution but a majority in our recent poll of 100+ doctors believe it will add cost, not limit skin cancer. But heading into 2022, these practitioners can evolve to impact health system costs in other...
Nov 16, 2021 | Home Health, Post-Acute Care
Home Health: For CY 2022, CMS finalized policies that will increase Home Health Agency (HHA) payments by +3.2%. This reflects the net impact of a +2.6% rate increase and fixed-dollar loss and rural add-on adjustments. Click to read more.
Nov 16, 2021 | Medicare, Physician Fee Schedule
End-Stage Renal Disease (ESRD): CMS has finalized a +1.9% increase to the ESRD base rate for CY 2022, and changes to the ESRD Treatment Choices (ETC) Model to continue to promote the use of home dialysis while addressing socioeconomic disparities between patients. Click to read more.
