Apr 26, 2018 | Uncategorized
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Physicians complain that a “severe delay” in updating the CMS Quality Payment Program interactive website, and other eligibility notification breakdowns have left them “in the dark on their status.”nnThe American Medical Association and more than 40 physician specialty associations are calling for the federal government to reduce from one year to 90 days the reporting period for 2018 Merit-based Incentive Payment System.nnIn a
letter to Centers for Medicare & Medicaid Services Administrator Seema Verma, the physicians’ associations say the curtailed reporting period is needed because:n
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- CMS failed to provide timely notification on physician eligibility for the program
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- The agency’s “severe delay” in updating its Quality Payment Program interactive website means it won’t be ready this summer
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nThe physicians say that the modifications to the Medicare Access and CHIP Reauthorization Act under the Bipartisan Budget Act exclude Medicare Part B drug costs from MIPS payment adjustments. Because of that, physicians cannot rely on any previous “historic” estimates to determine if they’re excluded under the low-volume threshold.nn”Thus, despite being held accountable for data tracking and collection as of January 1, 2018, physicians were not informed of basic eligibility information until early April to determine whether they must participate in the MIPS program,” the physicians told Verma.nn”Furthermore, in order to determine whether they are eligible for the MIPS program, a physician must actively go on to CMS’ website. Previously, CMS has mailed letters to practices to inform them of their eligibility status, which many practices were waiting on this year.”nn”Without direct outreach by CMS to physicians and group practices, many physicians will be left in the dark on their status,” the letter said.nnOriginal article posted on healthleadersmedia.com.nn
Apr 19, 2018 | Uncategorized
As online reviews become an increasingly popular way for patients to choose care providers, 82 percent of patients use online reviews to evaluate physicians and nearly half of patients (48 percent) would go out of their insurance network for a physician with better reviews, according to a Software Advice survey.nnTo determine how patients use online reviews for physicians, Software Advice surveyed more than 2,000 U.S. patients.nnHere are four survey findings:n
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- The majority (72 percent) of patients use online reviews as their first step in choosing a new physician, while 19 percent use online reviews to validate choosing a physician they have tentatively selected.
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- More than half (54 percent) of patients reported using reviews sites “often” or “sometimes,” while just over 25 percent of respondents use them “rarely.”
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- Only 7 percent of patients said they leave “very negative” or “somewhat negative” feedback on reviews sites, while a combined 52 percent of patients reported leaving “very positive” or “somewhat positive” feedback. Eleven percent of patients said they write “neutral” reviews.
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- Sixty-five percent of patients feel it is “very” or “moderately important” for physicians to respond to online reviews.
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nOriginal article posted on beckershospitalreview.com.
Apr 12, 2018 | Uncategorized
According to an article presented by Novitas Solutions, new Medicare cards will be mailed to qualifying patients, beginning April 2018. See below for complete article and schedule information.nnBeginning in April 2018, the Centers for Medicare & Medicaid Services (CMS) will mail new Medicare cards to all Medicare beneficiaries on a flow basis by geographic location and other factors.nnMailing Schedulen
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- April – June 2018nJurisdiction L – Pennsylvania, Maryland, Delaware and the Washington D.C. Metro Area (Arlington and Fairfax counties in Virginia, the city of Alexandria, VA, the District of Columbia, and Montgomery and Prince George’s counties in Maryland)
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- After June 2018nJurisdiction L – New Jersey, andnJurisdiction H – Colorado, Oklahoma, New Mexico, Texas, Arkansas, Louisiana, Mississippi, Indian Health Service and Veterans Affairs
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nAdditional details on timing will be available as mailings progress.nnStarting in April 2018, beneficiaries can check the status of card mailings in their area on Medicare.gov.nn Transition PeriodnA transition period will begin no earlier than April 1, 2018 and run through Dec. 31, 2019. During the transition period, you can use either the new Medicare Beneficiary Identifier (MBI) or the old Medicare Health Insurance Claim Number (HICN).nnStarting Jan. 1, 2020, you must use MBIs on claims regardless of the date of service.nnCMS Educational EffortsnTo prepare the health care industry for this change, CMS provided extensive outreach to the provider community and will continue to do so throughout the transition period. CMS holds regular Open Door Forum teleconferences to help you prepare your systems and business processes for a successful transition.nnCMS also initiated extensive education and outreach to Medicare beneficiaries and their agents to help them prepare and understand the change in Medicare cards and numbers. CMS produced flyers, posters, tear-offs and conference cards in multiple languages to assist providers when talking to their patients with Medicare about the new Medicare cards.nnFor the latest news and updates regarding the new Medicare cards, please visit the CMS’ New Medicare cards page on the CMS website.nnOur Educational EffortsnWe are committed to helping you and your Medicare patients successfully transition to the new Medicare card. We will continue to include important updates in our educational symposiums, webinars, face-to-face events, newsletters, and publications.nnFor upcoming educational opportunities, please visit our Education & Training Center (JH) (JL).nnFor more information, please review “New Medicare Cards and Numbers are coming – Beginning April 2018.”nnThis article and all information provided by novitas-solutions.com.
Apr 5, 2018 | Uncategorized
Its threat alone has helped speed consolidation, and consumers may suffer. nnWithout having done much yet, Amazon.com Inc. is already transforming U.S. health care — and not necessarily for the better.nnThe mere threat of the online giant getting into the health business prompted the country’s two largest pharmacy benefit managers — CVS Health Corp. and Express Scripts Holding Co. — to join forces with two of its largest insurers, Aetna Inc. and Cigna Corp. These deals will put more U.S. health care under the control of fewer companies. The merging companies say this will lower costs for consumers and the country. But the reality will likely be less rosy and more complicated.nnThat these companies can even make such deals is due partly to the Federal Trade Commission and the Department of Justice, which blocked the mergers of Anthem Inc. with Cigna and Aetna with Humana Inc. Those mega-insurers would have been too busy digesting to make big vertical deals and too large to be acquired by other insurers.nnUnitedHealth Group Inc. has been another major motivator for these mergers. It successfully pioneered a strategy of aggressive diversification by buying a large PBM in 2015 and with its Optum health-services unit. The gravitational pull of its success — it leads peers in patient enrollment, revenue growth, and market valuation — has inspired copycats. Profit pressure on PBMs, meanwhile, likely helped make them receptive to merging with insurers.nnBut Amazon’s long shadow also helped instigate these deals. With its technological prowess, long investment horizon, bottomless appetite for new business and tolerance for thin margins, any mention of its interest in health care rattles investors, particularly in the industry’s middlemen.nnIf the deals go through, the result will be an unprecedented level of market concentration.nnAll three of the biggest U.S. PBMs will be tied to three of the country’s biggest insurers. CVS, Express Scripts, and UnitedHealth process more than 70 percent of all U.S. prescriptions. Post-merger, three companies will insure more than 90 million people in some capacity, process more than 3.5 billion prescription claims, and generate more than $500 billion in revenue.nnNot every American will have both their medical and drug benefits managed by the same company. But many more will in the years to come. These integrated companies have more information about their customers and more ability and incentive to manage the totality of their health spending.nnUnitedHealth is already all-encompassing, with its continuing investment in everything from ambulatory surgery centers to physician groups. CVS and Aetna — which will add retail pharmacies and primary care clinics to the equation — could have an unprecedented role in patient lives. Read More >>nnCLICK HERE to view original article in it’s entirety, including informational charts, graphs and author info.
Mar 30, 2018 | Uncategorized
In celebration of National Doctors Day, we would like to honor and recognize the physicians who have made a difference in our lives and local communities. Doctors of all specialties do so much for us and we don’t often realize how much they contribute to our daily activities and overall well-being. From minor scrapes and viruses, to complete home health care when needed, doctors provide valuable information that allows us to take care of ourselves and our families. National Doctors Day is celebrated by showing special appreciation for physicians and displaying red carnations, the symbolic flower of Doctors’ Day.nnWhile we are thankful for all doctors, we would like to send a special “THANK YOU” to our clients as we celebrate YOU on this special day!
Mar 23, 2018 | Uncategorized
Welter Healthcare Partners has partnered with the Colorado Department of Public Health and Environment (CDPHE) Family Planning Program to provide training and technical assistance in cost setting activities to current Title X contractors and clinics. Our training and technical assistance will assist CDPHE and Title X contractors in updating fee schedules, developing sliding fee scales, identifying costs, and negotiating contracts with health plans. This 3 part web-based training series allows agencies to make informed decisions about the costs of doing business.n
Cost Analysis/Rate Setting
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