Tag Archive for ‘physician reimbursement’
Value-based contracts and their role in health care, namely, to control costs and support the provision of high-value health care goods and services, are described.
Today’s surgeon compensation models fall short: Aligning incentives to create more equitable and value-based compensation models
HIGHLIGHTS Summarizes the evolution of physician reimbursement models and the transition to value-based care Describes the continuum of surgeon compensation, ranging from fixed pay to exclusively volume-based plans Outlines how nonclinical activities create value for current and future patients Describes a better compensation model, one that incorporates value creation as a guiding principle Identifies the […]
HIGHLIGHTS Describes congressional committees’ perspectives on surprise medical billing Summarizes the bipartisan, bicameral agreement on the No Surprises Act Outlines patient protections under the No Surprises Act Provides an overview of payment dispute resolution processes For two years, from the end of 2018 through the end of 2020, congressional leaders explored different policy solutions to […]
Describes the public health provisions outlined in the American Rescue Plan, including COVID-19 vaccine distribution and expanded Medicare and Medicaid coverage.
This column provides a timeline of the events that led to the passage of the Omnibus Consolidated Appropriations Act of 2021, which directs the Centers for Medicare & Medicaid Services to postpone plans to eliminate payment for non-office-based evaluation and management services.
Editor’s note: This article was posted electronically with the January Bulletin so that surgeons would have access to the important information it provides regarding changes in Medicare payment that took effect that month. Because of delays in the release of the final rule on the updates, this information was unavailable when the print version of […]
HIGHLIGHTS Explains the difference between price and cost Describes methods for measuring both variables Underscores their importance in value-based payment model design Highlights ACS THRIVE Insurers increasingly tell surgeons that they need to reduce costs as health care grows unaffordable for a growing proportion of Americans. Similarly, hospital administrators frequently challenge surgeons to reduce their costs, […]
The College’s initiatives to address the challenges of 2020, including the coronavirus 2019 (COVID-19) pandemic and Medicare reimbursement cuts, as well as efforts to promote and ensure diversity, equity, and inclusion in all ACS-related activities, are summarized.
Editor’s note: This article is being posted electronically with the January Bulletin so that surgeons will have access to the important information it provides regarding changes in Medicare payment that took effect this month. Because of delays in the release of the final rule on the updates, this information was unavailable when the print version […]
The 2020 Medicare physician fee schedule: An overview of provisions that will affect surgical practices
This article reviews provisions in the 2020 Medicare physician fee schedule final rule that are relevant to general surgery and its related specialties.
This article provides guidance to assist Fellows in navigating their contractual relationships with the Centers for Medicare & Medicaid Services.
Congressional attempts to control Medicare physician spending through anti-inflationary policies are highlighted as are the future of Medicare payment updates under MACRA.
A summary of 2020 Medicare Physician Fee Schedule and Outpatient Prospective Payment System/Ambulatory Surgery Center proposed rule policies that could affect physician payment is provided.
Describes the College’s efforts to work with Congress and the Centers for Medicare & Medicaid Services to develop meaningful measures of surgical quality in the Quality Payment Program.
The correct use of modifiers 51 and 59 are explained, including case examples featuring clinical scenarios with correct coding.
The 2019 Medicare physician fee schedule: An overview of provisions that will affect surgical practices
This article summarizes provisions in the 2019 Medicare physician fee schedule final rule that are relevant to general surgery and its related specialties.
Physicians, nonphysician practitioners, and other Medicare Part B providers must enroll in the Medicare program to be paid for the covered services and items they provide to Medicare beneficiaries. Providers must make their 2019 Medicare determinations by December 31. As the deadline approaches and providers consider their options with respect to Medicare participation, this column […]
The restrictions regarding physicians’ ability to seek reimbursement for cost-sharing amounts from Qualified Medicare Beneficiary (QMB) enrollees are summarized as are practices to ensure compliance with QMB billing rules.
Provides an update on the Medicare inpatient-only list—which refers to procedures identified by CMS as typically provided in the inpatient setting and therefore not paid under OPPS—is provided.
This column provides an overview of efforts to reduce regulatory burdens on surgeons, looks at the regulations that are most onerous for surgeons, and describes ACS recommendation for reducing or eliminating these encumbrances.