by Continuum Health | Jul 18, 2018 | Blog, CMS, Coding, Payment Reform, Risk-Adjusted Coding
MEDPAC recently issued a report to Congress. It reviewed the reimbursement levels for office-based E/M codes versus procedural codes. The commission recommended a significant increase in the reimbursement of E/M codes. The increase ranged from 5% to 30% as a pay...
by Continuum Health | Jul 9, 2018 | Blog, Medicare Advantage, Risk Adjustment, Risk-Adjusted Coding, Value-Based Care
Physicians must code diagnoses properly to succeed under Medicare & other value-based contracts Each year, CMS sets cost benchmarks for every Medicare member, based on the patients’ diagnoses during the prior year. But what if the physician hasn’t reported their...
by Continuum Health | Jun 11, 2018 | Ambulatory Care, Blog, Health Access, Healthcare Innovation, Lower Cost of Care, Patient Experience, Quality Care, Telemedicine
Success in a value-based services environment requires physicians to: (1) continue improving the quality of their services, and (2) provide those services in an efficient manner to reduce the cost of care. In addition, physicians and ambulatory networks must strive to...
by Michael Renzi, DO, FACP | May 22, 2018 | Blog, CMS, Medicare Advantage, Patient Experience, Payer Contracts, Quality Care
CMS created the Star Ratings system in 2008 to help seniors compare quality and performance among Medicare Advantage (MA) Part C plans and Part D prescription drug plans (PDPs). Insurance companies also benefit, as a plan’s star rating influences patients and directly...
by Continuum Health | Apr 19, 2018 | Blog, CIN, Clinical Integration, Clinically Integrated Network, Independent Medical Practice, Independent Physician, Shared Services Model, Value-Based Care
Shared service providers help small physician practices transition to a value-based care environment. These organizations [i.e. Clinically Integrated Networks (CINs), Independent Practice Associations (IPAs), payers and/or private health care firms] also allow...
by Continuum Health | Apr 4, 2018 | Blog, CIN, Clinical Integration, Clinically Integrated Network, MACRA, Quality Care, Value-Based Healthcare
There is a trend in the local and national health care markets towards value-based contracting. This requires a focus on improving a practice’s quality score and reducing the cost of care. Clinically integrated networks (CINs) are integrated systems of physicians,...
