By a vote of 92-8, the U.S. Senate last night approved legislation ending the long-reviled formula for determining Medicare reimbursements. The vote came just hours before a 21% reimbursement cut would have gone into effect. The measure, which the U.S. House of Representatives passed three weeks ago, now goes to the president, who is expected to sign it.
Physicians today must understand a myriad of laws and regulations that govern not only how they practice medicine, but also how they bill and refer their patients for services both within and outside their own practice.
The push is on for physicians to embrace the concept of high-value care, providing patients with appropriate treatment while avoiding wasteful or unnecessary tests. But high-value care requires physicians to navigate many pitfalls, including lack of time to talk with patients and malpractice pressures.
It appears that the highly-anticipated repeal of Medicare’s Sustainable Growth Rate (SGR) formula-also known as the “doc fix”-will have to wait at least a couple of weeks longer.
As the annual Medicare Sustainable Growth Rate (SGR) deadline approaches March 31, legislators are once again scrambling to avoid a cut in physician payments, which this year would be about 21%. Physicians have long lobbied for a permanent fix to the problem, and lawmakers came close last year but couldn’t agree on how to fund it.
A study of 34 physician practices jointly sponsored by RAND Corporation and the American Medical Association found that alternative payment models are changing the way physicians and medical practices operate. However, changing the payment system doesn't always ensure patient care improves.
While a doctor may discharge a patient for any nondiscriminatory reason, termination is not without pitfalls. Physicians should follow a careful process so as to avoid claims of patient abandonment.
Physicians across the country are witnessing the advent of new payment models such as patient-centered medical homes, bundled payments, accountable care organizations, and other risk models. What do physicians need to know to incorporate-and succeed with-these payment models?
In the first-place winner for our 2015 Annual Physician Writing Contest, Daniel Taylor, DO describes his experience helping "Jeremy," a 15-year-old boy struggling with problems associated with obesity.
Many physicians doubt that electronic health records (EHRs) improve the quality of care. But relatively few practices are mining their EHR data to see how well they’re doing or to update their care delivery processes.
Electronic health records (EHR) use has steadily increased among office-based physicians since the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act, but new studies indicate that the number of physicians who don’t or plan to participate is substantial.
According to a new study from Johns Hopkins Bloomberg School of Health, only 53% of surveyed physicians use prescription drug monitoring programs (PMPs). Fewer than three-fourths of physicians knew about their state’s PMP.
The ability to share patient health information among providers has been a key government goal since passage of the Health Information Technology for Clinical Health (HITECH) Act of 2009 and the Affordable Care Act the following year. Partly as a result of those pieces of legislation, by 2013 about two-thirds of U.S. hospitals and half of physician practices were using some form of health information exchange (HIE) with other organizations. So far, however, there is little conclusive evidence demonstrating that HIE benefits individual patients or the healthcare system generally.
HHS’ announcement that, by the end of 2016, it aims to link 30% of Medicare reimbursements to the "quality of value" is the latest sign that, after years of talking about the importance of quality and outcomes in medicine, payers are getting serious about making them part of their reimbursement formulas.
Follow these tips to improve patient management and adherence of asthma treatments
You need to be specific in your ICD-9 coding for asthma because there are several codes available.
Even the most experienced physicians and practice managers face a daunting dilemma on the financial front: Should they handle billing and collections internally or hand over these tasks to an external vendor? There are strategies that physicians can use to evaluate potential vendors and make the best decision for their practice.
Ask these 10 questions before you choose a RCM vendor
Being sued for malpractice, especially for the first time, can be an unsettling and frustrating experience. The consequences of a lost case can range from an increase in future insurance premiums to a health department investigation which could affect your license. So it is imperative that you immediately report a malpractice claim to your professional liability insurance carrier and retain an attorney specializing in the defense of medical malpractice cases in order to protect your interests.
Treating chronic diseases such as diabetes requires a strong and open relationship between physician and patient.
Chronic care management can become an additional revenue stream for practices, but it requires understanding how to use the codes.
Rising costs can affect treatment adherence and lead to negative outcomes for patients. But physicians can take some small steps to help their patients overcome this challenge.
Despite changes to the Health Insurance Portability and Accountability Act (HIPAA) that dramatically affect the risk profile of medical practices, many have yet to establish a full arsenal of defenses against data breaches. The simple fact is that failure to update your protections can multiply your vulnerabilities and fines if a breach occurs.
Physicians who leave independent private practice to join a large group or a hospital system have different considerations when it comes to medical professional liability (MPL) insurance.
There are many ways to have a medical career. Choosing whether to take employment, buy a practice, or start from scratch involves assessing your personal and professional values, and the specific location you are targeting. The bottom line: Choose what will make you personally and professionally happy.
