CMS Pushing for Accountable Care Organizations

For those internet searching away for information on Accountable Care Organizations and the Medicare Shared Savings Program,  please ensure you are reviewing the final rules which were published on November 2, 2011.  The final rules relaxed many of the proposed rules in hopes of encouraging the formation of ACO.  One of the largest changes was

The RAC Audits are Coming!

RAC audits are becoming more common as auditors expand their reviews into additional states and specialties.  Many of the audits to date have been focused on hospitals and surgical practices due to the high revenues associated with these providers.  As the audits expand there are several things providers need to be aware of.  One of

ACO: Creating a Strong Foundation with a EHR

Accountable Care Organizations (ACOs) are meant to be a flexible payment and care delivery model that lowers total cost of care for patients using a group of coordinated health care providers. Hay Greens, a healthcare policy practice, recently released an article that outlined five preparatory actions to create a stable ACO. This article informs providers

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

A Good Primer on Accountable Care Organizations

In anticipation of MTBC’s upcoming webinar on Accountable Care Organizations, I’d highly recommend reviewing Health Capital’s “Accountable Care Organization Series: Why Do We Need ACOs.” The series does a nice job explaining the history and basic principles of the concept. Accountable care organizations (ACOs) – in which health care providers take responsibility for a defined

HIE: The Future of Electronic Medical Records?

Health Information Exchanges (HIE) are organizations that synergize and effectively streamline health information records. Many state governments provide funding for HIE implementation with the goal of facilitating access to and retrieval of clinical data to provide more timely, focused, and equitable patient-centered care. Even today, the federal and state governments have not clearly defined the

Medicare Wellness Visits: One Visit a Year… But 3 Codes?

Thanks to the Affordable Care Act, Medicare is (finally) covering yearly preventative, or “wellness,” visits for patients; however, the annual visit is actually separated into three different encounters.   Although each visit is largely similar, there are a few minor details separating each visit, and, as you know, these minor details must be followed as it

Get Your Flu Shots Here!

After assisting with the preparation and presentation of the flu shot webinar I truly believe that, armed with reminder calls, providers have a fighting chance of bringing in patients who would otherwise stop in a store to receive their flu vaccinations.  This idea really hit home when I visited family and friends in Washington D.C.

Relative Value Units/RVU’s, Whats the Big Deal?

Relative Value Units have been utilized to drive CMS reimbursement calculations since the early 1990’s. There are unique RVU values associated with each CPT billing code charged by a provider. Those values are defined for Practice RVU, Work RVU, and Malpractice RVU. These values are driven by a physician’s time, cost, and effort to provide

Grandfathered Plans under the Affordable Care Act

One of the more important and popular provisions of the Affordable Care Act is the expansion of access to certain recommended preventive care services – including flu shots – for patients at no additional charge to them. However, many health plans that existed on the day the ACA was enacted, March 23, 2010, known as