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Bundled Payments for Medicare Outpatient Services?
Come 2014, the Centers for Medicare and Medicaid Services (CMS) may push bundling of some outpatient procedures.
Come 2014, the Centers for Medicare and Medicaid Services (CMS) may push bundling of some outpatient procedures. The proposed rule change would be made in an effort to continue the streamlining of Medicare and Medicaid payment systems. Healthcare Payer News Reports:
The Centers for Medicare & Medicaid Services’ (CMS) 2014 proposed rules for the hospital outpatient prospective system (OPPS), released earlier this week, offer payment increases and “packaging” of services.
The proposed rule would increase hospital OPPS payments by $4.37 billion or 9.5 percent, and 2014 Medicare payments to ambulatory surgical centers (ASCs) by approximately $133 million or 3.51 percent, as compared to 2013, according to a CMS press release.
In its effort to continue streamlining the payment system, CMS proposes to “package” particular services and supports into seven new categories. A separate payment would still be made if an item included in a package is reported alone on a claim.
CMS also proposes collapsing the current five levels of outpatient visit codes to one.
Read the full story here:http://bit.ly/1drK65n
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Commonwealth Fund Report Details Pervasive Racial and Ethnic Disparities in US Health Care, Outcomes
April 18th 2024Using 25 health system performance indicators, the Commonwealth Fund 2024 State Health Disparities Report evaluated racial and ethnic disparities in health care and health outcomes both within and across US states and highlighted the urgent need for equitable health care policies and practices in the US.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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