Building upon experience from the Pioneer ACO Model and the Medicare Shared Savings Program (Shared Savings Program), the Next Generation ACO Model offers a new opportunity in accountable care—one that sets predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate care, and aims to attain the highest quality standards of care. Select anywhere […]
ACO stakeholders ask CMS to keep upside-only risk model, while 29 others from Next Gen ACO Coalition want to make risk more predictable. Susan Morse, Senior Editor Two interesting developments happened on Thursday that could impact the future of Accountable Care Organizations and the amount of risk they manage. First, 29 of the 51 Next […]
Remote patient monitoring programs offer multiple clinical and financial benefits, including reducing hospital admissions among patients, according to a new KLAS Research report. KLAS Research partnered with the American Telemedicine Association to examine success factors for remote patient monitoring programs at different healthcare organizations, including hospitals, payers and home health agencies. As part of the […]
By Kaitlyn Mattson | October 7, 2018 The home health industry has won another victory in Washington, D.C., in its battle against certain parts of the Patient-Driven Groupings Model (PDGM) and shift toward a more pre-acute care identity. Sens. Susan Collins (R-Maine), Bill Nelson (D-Fla.) and Debbie Stabenow (D-Mich.) introduced the Home Health Payment Innovation […]
Technological advances continue to expand the healthcare delivery marketplace. Through technology, more and more providers are trying to cash in on telehealth. As with any other business, the healthcare industry is driven by profitability. In healthcare, profitability is generally driven by reimbursements from government payers such as Medicare and Medicaid, private insurers such as Blue […]
By Robert Holly | September 17, 2018 Federal policymakers are again taking aim at costly administrative and paperwork burdens for the home health and hospice industries in order to help providers save tens of millions of dollars annually. The Centers for Medicare & Medicaid Services (CMS) on Monday announced its latest proposed rule focused on […]
By Mary Jo Gorman, MD, MBA ON September 14, 2018 An Increasing Number of Skilled Nursing Facilities are Catching the Telemedicine Wave Skilled Nursing Facilities (SNFs) nationwide are experiencing increasing challenges. These include sicker patients, higher turnover in staff, narrowing of referral networks, increased regulatory oversight and pressure to achieve certain clinical outcomes. Telemedicine is […]
By Maggie Flynn | September 10, 2018 Value-based arrangements generate much of their savings by shifting spending away from the post-acute setting, according to recent government announcements. That ups the already-high pressure on skilled nursing facilities to lower patient length of stay while maintaining quality of care. To cope, they’ll have to make themselves invaluable […]
The 2019 CPT code set includes new remote patient monitoring and internet consulting codes to encourage innovative care delivery and Medicare payment for connected health. September 07, 2018 – The American Medical Association (AMA) updated the Current Procedural Terminology (CPT) code set in 2019 to include new codes for connected health services in an effort to […]
CHICAGO—The American Medical Association (AMA) today announced the release of the 2019 Current Procedural Terminology (CPT®) code set. There are 335 code changes in the new CPT edition reflecting the CPT Editorial Panel and the health care community’s combined annual effort to capture and describe the latest scientific and technological advances in medical, surgical and diagnostic services. […]
Remote monitoring plus machine learning by Jeff Howell September 5, 2018 The future of home health will be a daunting journey during the next few decades as the industry faces challenges never seen before. The landscape looks like this: Many boomers are about to enter their 70s. People prefer to age at home. Health care […]
Aug 27, 2018 Today, the Centers for Medicare & Medicaid Services (CMS) released an evaluation report for the first performance year of the Innovation Center’s Next Generation Accountable Care Organization (ACO) Model showing promising early results. Results demonstrated the positive outcomes in terms of quality and costs when providers are responsible for managing to a […]
CMS has proposed three new codes for RPM services, retitled “Chronic Care Remote Physiologic Monitoring,” which do a far better job reflecting how providers can more effectively and efficiently use RPM technology to monitor and manage patient care needs, including chronic care management. If finalized, these three codes would go live January 1, 2019. CMS’ […]
August 20, 2018 As skilled nursing facilities handle more complex care, the need arises for physician input before sending patients to the hospital. Study findings reported this month in The American Journal of Managed Care® show that using telemedicine for this purpose can lead to fewer hospitalizations and savings for Medicare. CRANBURY, N.J.–August 20, 2018–When doctors could […]
The National Association of ACOs (NAACOS) argues that a rule proposed by the Centers for Medicare and Medicaid Services (CMS) to overhaul the Medicare Shared Savings Program (MSSP) begun in 2012 under the Affordable Care Act would create havoc by “introducing many untested and troubling policies.” “The administration’s proposed changes to the ACO program will […]