by Continuum Health | Oct 23, 2018 | Blog, Employer Provider Collaboration, Health Access
The cost of healthcare has become a burden on employers. As a result, employers are looking for ways to: Increase the quality and efficiency of medical services Eliminate the healthcare middlemen or payers These two goals have led employers to establish direct...
by Continuum Health | Sep 14, 2018 | Blog, CMS, EHR Technology, Healthcare Technology, Integrated Healthcare Technology, IT and Analytics, Population Health Tools
The Centers for Medicare and Medicaid Services (CMS) now supports improved health care interoperability efforts through applications that enable a data exchange between two disparate computer systems. One type of application programming interface (API) or data...
by Continuum Health | Aug 21, 2018 | Blog, Cost of Care, Physician Revenue
Some recent U.S. Department of Justice (DOJ) enforcement cases and settlements suggest that owning physician practices that are losing money may be a significant regulatory concern. The DOJ has suggested in the last few years that practice losses may be an indicator...
by Continuum Health | Aug 2, 2018 | Blog, Care Coordination, Claims Data, Clinical Integration, CMS, Cost of Care, Medicare Advantage
Medicare adopted transitional care management (TCM) payment codes in 2013 to encourage clinicians to provide TCM services after beneficiaries were discharged to the community from medical facilities. As a result, Medicare spending on TCM services increased over 200...
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...
