While the Affordable Care Act (ACA) seeks to open healthcare access to millions of uninsured Americans, there are seemingly just as many unanswered questions about its impact on physician practices in terms of costs, payer rules, quality of reimbursements, increased collections, and other issues associated with an influx of new patients.
A House bill that would repeal the dreaded SGR formula increases Medicare reimbursement to physicians by 0.5% per year. But given that the annual increase is less than inflation, is it a fair amount?
What immediately jumps out about the list of residency programs that produce the lowest percentage of primary care graduates is that it includes some of the biggest names in healthcare: Cleveland Clinic, Johns Hopkins, Brigham and Women's and plenty of others.
Many physicians recognize the need to control health costs in the U.S., but they're not eager to change how physicians are paid as a means of cost control, according to a new survey of physicians' attitudes about health cost containment published in JAMA.
The Patient-Centered Medical Neighborhood (PCMN) builds on the Patient-Centered Medical Home (PCMH) concept that’s designed to improve care coordination between primary care practices and specialists.
A new CMS proposal details two G-codes for primary care physicians for wellness and preventative care services and an expansion of telehealth services.
The U.S. population is healthier than ever, but compared to other wealthy nations, the U.S. is falling behind.
If you haven’t done so already, consider circling September 23, 2013 on your calendar. That’s the day that the federal government will start enforcing changes to the Health Insurance Portability and Accountability Act (HIPAA).
Opinions vary wildly on whether Obamacare will succeed, but there is little debate that Affordable Care Act will forever change the delivery of healthcare in the United States. Here's what it means for primary care physicians.
Medicare’s Physician Quality Reporting System (PQRS) currently offers .5% incentive to participate this year (1% with Maintenance of Certification); penalties will start in 2015 as a result of the Affordable Care Act.
The months are winding down until the health insurance exchanges mandated under the Affordable Care Act must be operational, and 17 states have declared their intent to open state-based exchanges, while seven have made plans for a partnership with the federal government, and another 27 have decided to let the feds take over their exchanges altogether.
The ICD-10 transition is a costly one for physicians, who must often purchase new information technology systems and train staff on the new coding system.
Medicaid expansion could save physicians and hospitals billions in uncompensated care costs. Yet fewer than half the states have agreed to increase their participation thresholds after challenging the expansion mandate before the Supreme Court last year.
October 3, 2013, is the last day doctors and other eligible professionals (EPs) can begin the attestation process to qualify for the first stage of meaningful use (MU1) in 2013.
Primary care physicians can, for the first time, get paid for transitional care management (TCM) - the time they spend coordinating care for patients transitioning from hospitals, nursing, or skilled nursing facilities back to the community.
Adapting to rapid changes, legislative pressures and fiscal uncertainty rank as the top challenges facing practice business leaders.
The Centers for Medicare and Medicaid Services (CMS) released hospital outpatient charge data for the first time.
Medicare commission’s report to Congress wants to even the payment disparity for some procedures performed in hospital outpatient departments (OPD) and office-based practices.
The National Committee for Quality Assurance (NCQA) wants to better integrate behavioral healthcare with primary care. In fact, the change is spelled out in new proposed standards for its Patient-Centered Medical Home (PCMH) program.
The FDA has approved the supplemental biologics license application (sBLA) for licensure of its 4-strain influenza vaccine, Fluzone Quadrivalent vaccine (Sanofi Pasteur).
Could you or your practice be at risk of complicity in Medicare fraud or abuse? The answer is almost certainly, YES.
Primary care physicians in a handful of states have already begun to receive higher Medicaid fees, but what's taking so long everywhere else?
Subspecialists recognized by the American Board of Medical Specialties (ABMS), American Board of Physician Specialties (ABPS), or American Osteopathic Association (AOA) qualify for the higher payments.
For years there’s been discussion in Congress about fixing the flawed SGR, but legislators have never been able to agree on a solution. But now, serious proposals are on the table to replace the SGR formula, with both Republicans and Democrats working together to reach a solution to this long-standing problem.
Direct primary care (DPC) is a retainer-based model for primary care practices, but does not come with a standard set of rules like many other models. Instead, there is a common set of goals or characteristics, and DPC practices are making their own rules as they go.
