By Tim Engelhardt – CMS released a report that demonstrates how empowering states can help reduce costs. The report summarizes the final Medicare Parts A & B actuarial savings analysis of the Washington managed fee-for-service demonstration…Read More
Fee for Service
By Marilyn Agbeko – Ah, the good old days; perform a procedure for a patient, submit claims and get paid. To get paid more, perform more procedures. Easy math. Success lay in managing the transactions between scheduling of services and receipts of payment so that you didn’t leave money on the table.
CMS is reporting these events and information on payment issues concerning Medicare and Medicaid. News includes updates on Inpatient Skilled Nursing Facility denials and Chronic Care Management Payment correction for RHCs and FQHCs.
By Crystal Ewing – Billing departments continue to be pressed by daunting challenges as the healthcare industry transforms from a fee-for service to a fee-for-value business model.
By Mordy Pelleg – For clinicians working in the complex American healthcare system, getting paid for every single procedure, service and visit has always been something of a challenge. Yes, fee-for-service medicine created a fairly linear relationship between effort and remuneration, but even in that scenario many hospitals and practices have teetered on the edge of solvency, in part for lack of efficient billing practices.
CMS is reporting these events and information on payment issues concerning Medicare and Medicaid. News includes updates on IPPS and LTCH Proposed Rule , Medicare Advantage quality data, Next Generation ACO Model, and Open Payment Data.
CMS is reporting these events and information on payment issues concerning Medicare and Medicaid. News includes updates on eCQM library and eCQI resources, SNF Value-Based Purchasing Program, Medicare Shared Savings Program, and the Clinical Laboratory Fee Schedule.
By Don Michaels PhD – The U.S. Department of Health and Human Services (HHS) has a stated goal of shifting 85% of Medicare fee-for-service reimbursement into value-based models by 2016. Private payers will no doubt follow close behind. Meeting this aggressive goal is causing angst among healthcare providers with much conjecture about what it means for their organizations going forward.
By Sharon Arnold PhD – Much has been written about the importance of finding alternatives to the volume-increasing incentives of traditional fee for service payments and one solution or change will not create an instant results. However, there is a continuum between pure fee for service and pure capitation.