Andria Jacobs, RN, MS, CEN, CPHQ

Andria Jacobs, RN, MS, CEN, CPHQ

Ms Jacobs is the chief operating officer for PCG Software and has more than 25 years' experience in the healthcare industry, encompassing both administrative and clinical arenas. Prior to joining PCG, Ms Jacobs was the administrative director, medical management for VertiHealth Administrators. Previously, she was an independent consultant in ambulatory care and practice management, where her clients have included hospitals, physician groups, and the University of California, Los Angeles.

Articles by Andria Jacobs, RN, MS, CEN, CPHQ

While the Merit-based Incentive Payment System (MIPS) has gone into effect for physicians that participate in Medicare Part B, many questions remain about the practicalities of the program. Physicians could also participate in advanced alternative payment models (APMs), but the vast majority of physicians and physician groups are expected to participate in MIPS.

Despite increased regulations and millions in drug distributor and pharmacy fines, opioid addiction continues to kill more than 33,000 people in the US each year. Opioid overdoses have quadrupled since 1999, according to the CDC. Payers and providers should be doing their parts to stem this tragic epidemic by examining claims data more closely.

One of the primary drivers of healthcare waste is administrative inefficiency. While the industry implements remedies and solutions with electronic prescriptions and electronic claims transfer and processing, the gorilla in the room that no one mentions is CMS.

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