More billing codes, demonstrations help bridge physician payment gap

Insurance agent using calculator for medical insurance, the policy and explain insurance policy to customer. life insurance concept.
In the 2018 Medicare Physician Fee Schedule, CMS said it is working incrementally to “identify gaps in appropriate coding and payment for care.”
“A new Robert Wood Johnson Foundation (RWJF) report analyzed how CMS has expanded billing codes and demonstrations focused on supporting primary care.  The report said primary care providers (PCPs) involved in CMS demonstrations are getting higher monthly payments. The shift has meant more up-front payments rather than end-of-year bonuses. Those providers are also being held accountable for a wide range of outcomes, but often “not expected to independently influence the total cost of all care received by Medicare beneficiaries,” according to the RWJF report.” Read the full article.
Check out this article and more on social media!

Related Posts

Managing Operational Volatility During Medicaid Redeterminations

Medicaid redeterminations place intense operational pressure on health plans. Eligibility teams, enrollment operations, member services, billing, and provider support often ...

Modern Provider Network Management for Commercial Plans

By Norah Brennan, SVP of Product Development  Commercial network management is evolving. What was once viewed primarily as a contracting ...

Why Provider Data Accuracy Matters More Than Ever in Public Programs

Provider data accuracy is not a back-office housekeeping issue. In public programs, it is an access issue, a compliance issue, and ...

Want To Know How We Can Help Your Organization?