Author Archive

Will You be Among the 87% Penalized under MIPS?

According to CMS data, 87% of solo providers and almost 60% of 2 – 9 provider practices are at risk of being penalized under the new Medicare-based Incentive Payment System (“MIPS”).  Don’t feel badly if you’re asking, “what is MIPS?”  — you still have time to learn about MIPS and ensure you’re not penalized. Under

Health Information Exchanges: They are coming, but is your Office Ready?

Industry-wide electronic health record (EHR) utilization brings with it exciting promises of improved quality of care, increased efficiency and reduced cost. However, the full positive impact of EHR utilization will not be truly realized until providers and entities are seamlessly sharing health information in such a manner as is facilitated by health information exchanges (HIE).

My New Years’ Resolution: Earn A Meaningful Use Bonus (Part One)

Whether you have yet to start using an EHR or have already adopted an EHR and earned a bonus, you may want to seriously consider adding “I will earn a meaningful use bonus” to your list of to-do’s for 2013. If you have not yet adopted an EHR, it’s not too late.  While the first

Obtaining PCP Reimbursement for Post-Discharge Transitional Care Management

If you are a primary care provider, you may be pleased to learn that Medicare will begin providing reimbursement for post-discharge transitional care management (TCM).  In particular, Medicare will pay providers between $163.91 and $230.90 for care provided in a non-facility setting (assuming that Congress acts to prevent the 26.5% cut). Other authors in this

Will Medicare reimburse you for Skyping during 2013?

In 2001, Medicare began providing reimbursement for certain procedures performed via telehealth, but the scope of those services was so limited that a small percentage of providers benefited from the new policy.  Changes in the 2013 fee schedule are poised to somewhat alter this dynamic and make it possible for  a growing percentage of providers

Increasing Practice Revenues with effective Ophthalmology Appointment Reminders

Busy ophthalmology practices focused on increasing revenues use a variety of techniques to increase efficiency and maximize reimbursements.  Perhaps the lowest hanging fruit for accomplishing this objective is a simple technique that is often overlooked by ophthalmology practices: Effective appointment reminders. Studies consistently show that a typical office experiences no-show rates ranging from 15 to

Considering an ACO? You Need to Start Planning Now

If you’ve read our blogs regarding Medicare’s new ACO model, perhaps you’re wondering how you can get started and how long the process will take. The below chart provides a general overview of what you can expect relative to the typical application process.   It’s important to note that the window for beginning the ACO

Medicare Accountable Care Organizations: Steps to Getting Started

While the excitement surrounding Medicare Accountable Care Organizations (ACO) is clearly reverberating throughout the physician community, there continues to be a significant knowledge gap regarding the basic steps that must be taken to form an ACO. While a blog cannot provide a full step-by-step guide to ‘getting started’, I will address the relevant key considerations

CMS Penalties for Readmissions Create Additional Momentum Toward ACO Formation and EHR Utilization

Bonuses for successful accountable care organizations (ACO) have created quite a ‘buzz’ in the healthcare community. Two new developments – penalties for hospitals and quality of care data published online by the U.S. Department of Health and Human Services (HHS) – will build on this momentum and increasingly drive Accountable Care Organizations formation. Earlier this

JAMA Study Concludes that ACOs are Poised to Improve Care and May Lower Costs

A study just published in the Journal of the American Medical Association (JAMA) suggests that the accountable care organization (ACO) model shows promise at improving quality of care and may provide some reduction in the rate of cost growth. On September 12, 2012, JAMA published the results of a study that examined the performance of