Five Emerging Trends in Value-Based Care

Five Emerging Trends in Value-Based Care

The practice of value-based care has gained significant momentum, driven in part by the COVID-19 pandemic, which highlighted the limitations of fee-for-service reimbursement. Healthcare providers now face increasing pressure to stay up-to-date with emerging trends in the field. In this article, we’ll explore five key trends in value-based care.

 

1) Embracing Value-Based Care:

A heavy reliance on fee-for-service reimbursement can leave healthcare providers vulnerable to volatility and changes in demand. Those who had invested in value-based care were better equipped to weather the storm, as they had a consistent source of revenue even during periods of low utilization. The rapid changes in healthcare delivery driven by the pandemic underscore the importance of embracing value-based care. Providers have the opportunity to realize a rapid return on their investment in value-based care, thanks to stable revenue streams and new regulatory flexibilities. Innovative care delivery models further enhance this potential.

 

2) Continued Innovation and Disruption:

Value-based care has long been a hotbed for innovation, and we are seeing a surge in innovation and disruption in both payment and care delivery models. The Centers for Medicare and Medicaid Services (CMS) had prioritized value-based care during the Trump administration, and the Biden administration’s health care goals are likely to further emphasize cost savings, driving a greater push towards value-based care. Commercial payers are also seeking innovative payment and care models, especially in light of the disparities highlighted by the pandemic.

 

3) Leveraging COVID-19 Infrastructure:

The COVID-19 pandemic prompted transformative changes to the healthcare system. These changes created ongoing opportunities to manage patient care and provide high-quality services in lower-cost settings. Telemedicine and digital health modalities, initially introduced as temporary measures, have become permanent fixtures in healthcare. Providers who adopted digital health solutions during the pandemic can now capitalize on this investment to manage patient care efficiently and see returns on services that were traditionally unreimbursable under fee-for-service arrangements. Programs like the Hospital Without Walls and Acute Hospital Care at Home have also opened doors for lower-cost services that benefit providers.

 

4) New Opportunities for Provider Alignment:

Recent changes in federal law have aimed to lower barriers to value-based care. CMS and the Office of Inspector General (OIG) have introduced new flexibilities under the Stark law and Anti-kickback Statute for value-based arrangements, allowing providers to enter into arrangements that were previously restricted. These exceptions and safe harbors provide new opportunities for providers. Careful crafting is required to take advantage of these allowances. They enable providers to align and incentivize activities that promote value-based goals. Additionally, information blocking rules ensure patients and providers can access health information, further reducing structural barriers to value-based care.

 

5) Focus on Social Determinants of Health:

In the value-based care space, especially in Medicaid programs, there is a growing emphasis on addressing social determinants of health. Providers and payers recognize the significant role that non-medical factors play in patient health. Providers and payers can achieve notable improvements in patient health and outcomes by addressing issues such as transportation, food, housing, and language services. Simultaneously, they can maintain relatively low medical costs. The focus on social determinants of health is an emerging trend in value-based care. This trend is expected to grow as stakeholders seek creative ways to manage patient arrangements.

 

Healthcare providers and payers are emerging from the upheaval caused by the pandemic and the revolutionary changes in healthcare. A renewed interest in value-based care is expected! Opportunities abound to fully investing in patients.

 

Post adapted from original article published on natlawreview.com 
Photo from NCI
NEW 2024 ICD-10-CM Codes Deliver Over 400 Significant Editorial Changes

NEW 2024 ICD-10-CM Codes Deliver Over 400 Significant Editorial Changes

The Healthcare Code Landscape Is About To Witness A Significant Transformation

The Centers for Medicare & Medicaid Services (CMS) have recently unveiled the ICD-10-CM 2024 codes. These updates, slated for use by all provider types, encompass both Inpatient and Outpatient settings. The release includes crucial components such as the 2024 Addendum, Code Descriptions in Tabular Order, and Code Tables, Tabular, and Index. Alongside these, the FY 2024 Conversion Table and Present on Admission (POA) Exempt Code List (to be posted soon) complete the comprehensive package of changes.

The 2024 ICD-10-CM changes take effect from October 1st, 2023, to September 30th, 2024. Providing the medical community with a significant overhaul of 

395 New Codes, 25 Deletions, and 13 revisions across 17 of the 21 Chapters! 

Notably, Capturing the Context. Great Job Docs! Your excellent documentation of Where and/or How injuries happened has given way to a major boom in Chapter 20: External causes of morbidity! A whopping 123 new codes out of the 395 overall additions to be exact! These additions range from “Foreign bodies entering through a natural orifice” like batteries, buttons and plastic toys to sharp glass, swords and daggers”! 

Some Other Major Changes Include: 

  • Chapter 3, Neoplasms, a notable addition to includes 13 new codes for desmoid tumors, a rare type of tumor that presents unique challenges in terms of classification and treatment. Chapter 3 introduces 8 new codes related to Sickle-cell conditions with dactylitis. This is a condition marked by severe inflammation of fingers and toes, commonly observed in infants with sickle cell anemia.
  • Chapter 6, the Nervous System, focusing on diseases of the nervous system, welcomes 24 new codes, including those for Lafora Body Disease and chronic migraine with aura. These additions reflect a growing understanding of neurological conditions and their complexities.
  • Chapter 21, Factors Influencing Health Status and Contact with Health Services, 30 New Codes include a variety of conditions such as carrier status, history codes, and codes related to Social Determinants of Health (SDOH), like New Subcategory Z62 which addresses “Problems Related to Upbringing”; and New Subcategory Z91.A9 “Caregiver’s Noncompliance with Patient’s Medical Treatment and Regimen”. 

The changes aren’t limited to specific areas; they permeate through various chapters, addressing an array of conditions and diseases

Learn more about the author Delana Williams, CPC, CPCI, CEDC 


ICD-10 Questions?

If you have any questions or need clarification about the 400 changes to ICD-10 CM for 2024 please contact us. We are here to help!

Medical Coding & Billing newsletter 

Keep informed about the ever changing and complex landscape of medical billing and coding, ICD-10 CM and revenue cycle optimization  related subjects. Sign up for our “Coding & Billing” newsletter for comprehensive answers, updates, clarification and advice.

Welter Healthcare Partners stands ready to navigate these modifications effectively and provide the utmost support in adapting to the evolving ICD-10-CM landscape. Our team is well-equipped to ensure the accurate coding and compliance essential for seamless healthcare billing operations in this changing environment. 

 

Information collected and condensed by 

Delana Williams, CPC, CPCI, CEDC 

Coding and Compliance Manager at Welter Healthcare Partners.

 

Want to learn more? WHP will be hosting TWO ICD-10-CM UPDATE WEBINARS. Stay tuned for more info!

 

Photo by National Cancer Institute on Unsplash
Strategies to Improve Specialty Healthcare in the United States

Strategies to Improve Specialty Healthcare in the United States

Specialty Healthcare in the US

Many doctor visits involve seeing a specialist at some point in the process. The specialty healthcare system in the United States needs to be improved in order to help patients and doctors alike. Specialists are important in American healthcare. 

Almost 9 out of 10 doctors specialize in different areas. They handle a big part of medical visits, cost a lot in Medicare and private insurance, and their role in outpatient visits and overall healthcare costs is increasing. To improve healthcare in the U.S., we need to make specialty care better. We can do this by breaking it down and making the various services offered by specialists work well together.

 

Core Activities of Specialists

Specialists are problem-focused experts responsible for the care of individuals with specific health conditions. They expand their expertise through a range of core activities, including: 

  • Consultations (providing advice to fellow clinicians)
  • Co-management (sharing the long-term management of a particular issue)
  • Principal care (assuming full responsibility for a specific problem)
  • Primary care (offering a medical home)
  • Procedures

The blend of these activities varies based on a specialist’s field and individual practice. For example: 

  • Cognitive-based specialists, like endocrinologists and nephrologists, tend to engage in consults, principal care, primary care, and co-management, often with minimal or no procedures. 
  • Procedural-based specialists, such as gastroenterologists and cardiologists, also partake in consults, principal care, and co-management, in addition to procedures but provide little to no primary care. 
  • Surgical specialists, including orthopedists and neurosurgeons, primarily engage in consults and procedures.

 

Challenges of Bundling

In various industries, bundling products and services with multiple components is commonplace to reduce production and distribution costs. However, including elements that some consumers never utilize can lead to increased costs and a potential mismatch with individual consumers’ specific needs. Specialists often employ uniform processes, resources, and business models to deliver widely differing services. 

This bundling approach makes specialty care less accessible; for instance, individuals in need of prompt attention may face delays due to specialists’ schedules being occupied by those receiving ongoing care. It also inflates costs for simpler services due to unnecessary overhead, disrupts the patient experience with cumbersome processes, and diminishes effectiveness when resources are insufficient for complex requirements. Additionally, it places undue strain on specialists and their staff, who must frequently shift their focus between highly disparate tasks.

 

Unbundling as a Path to Improvement

The internet’s influence in reducing distribution costs has allowed many companies to unbundle products and services into stand-alone offerings that are more affordable and cater to specific consumer needs. Breaking down specialist activities into modular components and delivering each with tailored clinical, operational, and business models could potentially make specialty care more accessible, cost-effective, efficient, and patient-friendly. Below are strategies for unbundling the four core services of specialists:

  • Consultations: Provide stand-alone consultation services, enabling patients to seek expert advice without committing to long-term care.
  • Co-Management: Develop specialized co-management programs for patients with ongoing conditions, streamlining their care without compromising efficiency.
  • Principal Care: Offer principal care as an independent service, providing individuals with comprehensive management of specific health issues.
  • Procedures: Establish specialized procedure clinics, ensuring that patients receive necessary treatments promptly without delays caused by bundled care models.

In conclusion, revamping the U.S. specialty healthcare system involves breaking down the traditional bundled approach and reimagining specialist services as individualized, efficient, and accessible components. This shift towards unbundling holds the potential to address the existing challenges and enhance the overall quality of specialty healthcare in the United States.

 

Original article published on hbr.org 

Read more on welterhp.com

The Medicare Physician Payment System Needs A Comprehensive Solution – Not Temporary Fixes

The Medicare Physician Payment System Needs A Comprehensive Solution – Not Temporary Fixes

Physician Compensation And Medicare:

When it comes to physician compensation within the Medicare system, it often feels like we’re applying quick fixes rather than addressing the underlying issues. Instead of constantly maneuvering to avoid these pay cuts, it’s important for the government to take steps towards creating a sustainable payment system. In this article, we’ll delve deeper into this ongoing challenge.

2% Reduction In Medicare Payments In 2023

The recent efforts by the American Medical Association (AMA) to mitigate an impending 8.5% Medicare pay cut in the 2023 omnibus spending bill managed to slow down the impending crisis but didn’t bring it to a complete halt. Physicians are still poised to experience a 2% reduction in Medicare payments this year, with a further 1.25% cut looming in 2024. Relying on stopgap measures and perpetually averting cuts year after year is an unsustainable practice, as emphasized by Todd Askew, the Senior Vice President of Advocacy at AMA.

In the initial stages of 2023, Medicare physicians were confronted with a daunting 8.5% reduction in their payment rates. This significant reduction stemmed from a combination of factors, including the expiration of a 3% bonus designed to account for evaluation and management (E/M) increases, the introduction of new E/M values necessitating a budget-neutral adjustment of 1.5%, and an additional 4% cut attributed to pay-as-you-go (PAYGO) measures aimed at curbing excessive spending. Todd Askew observed, “The timing couldn’t have been more unfavorable, particularly considering that many practices are still grappling with the financial aftermath of reduced revenue during the peak of the pandemic.”

PAYGO Cut Successfully Averted

Through collaborative efforts, the American Medical Association (AMA) joined forces with 150 other physician organizations and healthcare groups to diligently prevent these impending reductions. Todd Askew, in reflecting on these advocacy endeavors, noted some positive strides. He stated, “In the larger picture, we managed to delay the 4% PAYGO reduction, effectively eliminating it for this year.” Furthermore, Congress orchestrated a phased reduction of the physician bonus, which offsets the E/M increases, reducing it to 2.5% for the current year, with an additional reduction planned for 2024, bringing it down to 1.25%. Lawmakers opted not to address the counterbalancing of the heightened E/M values, which were responsible for other budget-neutral cuts. All in all, this translates to approximately a 2% reduction in Medicare reimbursement fees from 2022 to the present year, as succinctly explained by Askew.

Medicare Participation Under Scrutiny

While a 2% reduction may be preferable to the initially proposed 8.5%, the impending decrease will cause medical practices to confront challenging decisions. Some practices are already operating on razor-thin margins, with a 2% or even 0% margin. “This situation will undoubtedly prompt many practices to reevaluate the feasibility of their participation in the Medicare program,” he stressed.

For older adult patients, this predicament is likely to lead to widespread access issues across various specialties and healthcare services throughout the country. The ongoing erosion of Medicare payments when compared to inflation will undoubtedly carry long-term repercussions, as pointed out by Askew. Physicians have already witnessed a cumulative reduction of 22% in their payments over the past few decades. Askew underscored this by stating, “This reduction is primarily a result of the underlying payment system’s lack of a mechanism for regular increases to keep pace with the rising costs of inflation.”

A Call for Congressional Attention

Notably, Congress has not undertaken any substantial review of the existing payment system since its inception under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. The 2% reduction serves as an alert to Congress, urging them about the ongoing cuts and the gradual devaluation of Medicare payments. This poses a substantial threat to healthcare access.

Askew strongly urged physicians to remain engaged through the AMA’s social media platforms and to remain vigilant for alerts from the Physicians Grassroots Network. “We cannot afford to wait for another crisis because it is highly likely that we will face further reductions in the coming year,” he cautioned. This article was originally published on ama-assn.org.

Welter Healthcare Partners Can Help
  • REVENUE CYCLE MANAGEMENT (RCM) PROGRAMS: Increase your Revenue & Cash Flow to ensure financial stability, so you can focus on delivering exceptional patient care
  • PROVIDER ENROLLMENT: Managed program eligibility, timely re-credentialing, and compliance that ensures revenue integrity.
  • CREDENTIALING / CVO: Verified provider qualifications and training, equals quality patient care.
  • CODING COMPLIANCE: Welter Healthcare Partners stays informed of changing coding standards helping you to maximize reimbursement and mitigate risk
Consumer-Focused Metrics Approach Is Important For Healthcare Systems

Consumer-Focused Metrics Approach Is Important For Healthcare Systems

In The Rapidly Evolving Landscape of Healthcare

Patients are no longer tethered to a singular provider network. They are now opting instead to distribute their care across a multitude of platforms. As the industry adapts to this shifting paradigm, healthcare providers must use the power of data and establish comprehensive metrics to truly understand patients as consumers. Integrating consumer-focused metrics into strategic planning presents certain complexities. However, it is an essential step for healthcare systems aiming to stay competitive in this dynamic environment. Continue reading to explore the challenges faced by health systems as they endeavor to integrate patient data effectively.

The Evidence Is Stark

American patients are no longer steadfastly loyal customers. Each year, they diversify their care across an average of four to five distinct provider networks. The healthcare landscape boasts an array of choices, spanning from innovative virtual and primary care providers to emerging retail players and urgent care facilities. It’s not surprising that patients seek diversity in their healthcare experiences. To remain competitive, traditional health systems and provider organizations must embark on a journey to comprehend patients in their roles as healthcare consumers. Understanding the intricate mechanics behind their decision-making processes, their underlying motivations, and the how, where, and why of their engagement within the broader healthcare ecosystem.

Additionally, they must decipher how the dynamics of supply and demand shape the markets in which they operate. Indeed, the battle for patient engagement is on the horizon. A staggering 44% of Americans are active Amazon Prime members, contributing to Amazon’s extensive reservoir of consumer data for its ongoing healthcare expansion and targeted strategies. The largest healthcare system in the nation, HCA Healthcare, engages with only 1% of Americans through its care delivery system. As healthcare providers, hospitals, and health systems navigate this new terrain, they must take a page from the playbook of tech giants like Amazon. They need to start adopting consumer-focused strategies to thrive in a shifting healthcare economy valued at $4.3 trillion. This journey begins with data utilization and metric establishment.

 

Two Pivotal Challenges

One of the foremost challenges encountered by health systems in their pursuit of consumer-focused metrics integration lies in the limited scope of data tracked in this domain. Another hurdle is the reliance on a handful of traditional consumer/patient satisfaction metrics, such as the Net Promoter Score (NPS) and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, to project future patient behavior. For example, this will forecast a patient’s likelihood of returning to the same system for care based solely on their self-reported satisfaction with a prior hospital experience. However, patient satisfaction does not serve as a reliable metric of future actions. A patient’s consumer profile may deviate significantly from their intentions.

Healthcare leaders should refrain from banking on patient satisfaction measures to predict and account for future patient behaviors. Instead, they must scrutinize patients’ actual behaviors and weave this information into their strategic planning fabric. To fortify their competitive stance and vie for a dwindling pool of patients, health systems must establish clear-cut measures and metrics that better cater to consumer needs—whether at the individual, organizational, or market level. Among these, two critical categories of metrics warrant diligent attention:

Consumer-focused Preferences and Proclivities

Retail giants like Amazon and Walmart have adeptly employed data from consumer-focused metrics to study diverse customer segments, tailoring their services accordingly. Amazon’s recommendation engine communicates with shoppers through personalized product suggestions, based on past purchases and potential interests. Regrettably, healthcare systems and the broader health economy have lagged behind in adopting such data-driven practices, even though they are indispensable for long-term patient engagement. Health systems must probe deeper to decipher whether a patient’s absence results from a lack of available appointments or a preference for another provider organization.

While some questions may prove more challenging to answer, enhancing technological infrastructure allows health system leaders to deploy data engineering resources effectively, linking patient healthcare utilization patterns with behavioral profiles on a grand scale.

  • Does the data unveil patterns of no-shows or cancellations during specific hours?
  • Does the integration of consumer behavior data unveil fresh insights into the behavior of distinct patient demographics at different times of the day?
  • Can psychographic profiles elucidate internal dynamics or identify reasons behind the loss of market share in specific specialties?

These are the real-time insights that become apparent when health systems collectively harness healthcare and patient behavior data, exploiting resources readily available within the healthcare ecosystem. By grasping the driving forces behind consumer behavior and decision-making, health systems can take tailored steps to engage and serve healthcare consumers, all while respecting their preferences and needs.

Share of Care

Organizations outside of healthcare that take consumer-focused metrics into consideration invest into understanding the economic underpinnings of their businesses. They diligently track their total addressable market, market share/value, and strategies to outperform competitors. Healthcare systems should adopt the same ethos. They must transcend mere revenue targets and delve into understanding their “share of care” within their respective markets.

Utilizing Internal and External Data

What proportion of a health system’s treated patients received care interactions outside the purview of that health system? Health system leaders can look at internal data, encompassing patient journeys across care settings and individual electronic medical records. External data, including local U.S. Census data, benchmarks, and indicators of leakage from health plans, also provide valuable context. Understanding the total addressable market and applying patient behavior metrics are essential for strategic investment decisions. Many health systems have invested in specific access points, such as telehealth and urgent care, with the expectation that these will serve as the “front door” to care, securing patient loyalty for future procedures and healthcare needs.

Utilizing Longitudinal Patient Data

However, longitudinal patient journey data reveal that this hypothesis does not always hold true. This realization can significantly impact service line and investment decisions. Unfortunately, data fragmentation and lagging interoperability initiatives impede access to such vital information. Electronic medical records data, while informative, often neglect patient interactions beyond the walls of a health system’s organization. In a landscape offering more healthcare options than ever before, knowledge is the most potent asset at the disposal of health systems. The healthcare delivery landscape grows increasingly competitive. So, health systems must become data-driven, and align with metrics specific to patients. Armed with consumer-centric insights, health systems can prepare themselves to compete for a share of care in an environment where the supply surpasses current demand for services. The original article was published on hbr.org.

How Welter Healthcare Partners Can Help With Consumer-focused Metrics

With decades of experience we take pride in helping Hospitals, Private Practices, and offices across the US. Using our services like Revenue Cycle Management, or Provider Enrollment, can ease the burden of “back office work”. This will open up your employees time to focus on the happiness of patients!

Educating Patients for a Positive Financial Journey

Educating Patients for a Positive Financial Journey

Patients & The Billing Process

Here at Welter Healthcare Partners, we acknowledge and applaud the dedication of revenue cycle leaders who tirelessly work to benefit patients, including financially. A critical aspect of ensuring a positive patient experience is providing education to guide them through the billing process. 

At a recent HealthLeaders Patient Financial Experience Summit, Mary Neal, AVP of Revenue Cycle at Ochsner Health, and Savanah Arceneaux, Director of Pre-Service and Financial Clearance at Ochsner Health, joined a summit session to discuss strategies for creating and streamlining patient education resources. These strategies aim to improve patient satisfaction, particularly in the face of challenges like the No Surprises Act.

Patient Billing Challenges

Revenue cycle staff are faced with the complexities of billing statements and good faith estimates, placing a significant burden on their shoulders when assisting patients in navigating these intricate documents. In todays landscape a subpar financial experience can overshadow a five-star clinical encounter. Therefore, revenue cycle leaders are under increasing pressure to streamline processes for their patients. So, what’s the key to addressing this challenge? Neal and Arceneaux emphasize the importance of comprehensive patient education. Additionally, emphasis on payer and cost education throughout the revenue cycle is crucial.

Financial Responsibility

“In recent years, payers have shifted more financial responsibility onto patients, presenting a significant challenge. This shift has driven us to reevaluate our long-term strategic vision for creating a more consumer-friendly experience. We’ve opened a digital front door, offering patients various options to access resources and education about their plans,” noted Arceneaux. This approach has led Ochsner to embrace services and technology that facilitate closer patient engagement and connection even before their scheduled visit.

“While we aim to collect owed payments as a patient-centered organization, we also want to involve our patients every step of the way. We strive to ensure they are financially informed before their visits, contributing to their overall satisfaction,” Arceneaux added.

Help your practice or hospital get ahead of billing challenges by contacting Welter today!

The OIG’s Overhaul of Compliance Guidelines: What You Need to Know

In a significant development for the healthcare industry, the HHS Office of Inspector General (OIG) has announced a major overhaul of compliance guidelines for individual and small group physician practices. This much-anticipated update comes after nearly 23 years and is part of the OIG’s broader modernization plan. As healthcare compliance experts, Welter Healthcare Partners is committed to keeping you informed and helping you navigate these changes to develop strong and efficient compliance programs. In this article, we will delve into the details of the OIG’s planned revisions and what they mean for your practice.

The Roadmap to Modernization

The OIG’s modernization plan, outlined in the Federal Register notice titled “Modernization of Compliance Program Guidance Documents,” aims to provide updated and comprehensive compliance guidance for healthcare entities. The first round of upgrades is expected to be rolled out by the end of 2023, starting with the general compliance program guidance (GCPG).

Key Areas of Focus

The GCPG will cover a wide range of critical topics, including:

  • Federal Fraud and Abuse Laws: Understanding and complying with federal fraud and abuse laws is paramount for healthcare providers. The updated guidelines will offer clarity on these laws and how they apply to your practice.
  • Compliance Program Basics: Establishing a robust compliance program is the foundation of ensuring ethical and lawful healthcare operations. The GCPG will provide insights into the fundamental elements of such programs.
  • Operating Effective Compliance Programs: Practical guidance on how to operate and maintain an effective compliance program will be a central focus. This will help healthcare entities streamline their processes and ensure ongoing compliance.
  • OIG Processes and Resources: Understanding how the OIG operates and the resources available for compliance will be essential for healthcare providers. The guidelines will shed light on these aspects to facilitate cooperation and communication.

Timeline for Implementation

The OIG plans to publish the GCPG by the end of the calendar year 2023. Subsequently, industry-specific guidance will follow in 2024. These tailored guidelines will be designed to meet the unique needs of various healthcare providers, suppliers, and participants in different subsectors of the healthcare industry.

The OIG’s initial target for industry-specific guidance includes Medicare Advantage and nursing facilities. However, over time, guidelines for other healthcare sectors are expected to be developed. Importantly, the OIG has confirmed that these compliance guidelines will remain voluntary.

Embracing Voluntary Compliance

The OIG’s intention has always been to create a voluntary set of guidelines and identified risk areas. These guidelines are meant to assist individuals and entities in the healthcare industry when developing or evaluating their compliance programs. While they are not mandatory, adhering to these guidelines demonstrates a commitment to ethical and lawful healthcare practices.

How Welter Healthcare Partners Can Help

At Welter HP, we provide a comprehensive suite of coding services tailored to meet all the coding needs of your medical practice. Our dedicated team excels in compliant coding, precise documentation, and efficient billing practices. With the impending changes in compliance guidelines, our team will be diligently tracking the OIG’s revisions as they are announced. We are dedicated to helping our clients adapt to these changes and develop compliance programs that align seamlessly with the new guidance.

The OIG’s overhaul of compliance guidelines for individual and small group physician practices marks a significant step towards modernizing compliance in the healthcare industry. While the changes are expected to be rolled out gradually, it is crucial for healthcare providers to stay informed and prepared. Welter HP is here to support you through this transition, ensuring that your compliance programs remain strong, efficient, and aligned with the evolving guidelines. Together, we can continue to uphold the highest standards of ethical and lawful healthcare practices.

Talk to an expert today!

More than a Name Change; It’s Who we are TODAY

More than a Name Change; It’s Who we are TODAY

FOR IMMEDIATE RELEASE

More than a Name Change; It’s Who we are TODAY

 

July 13, 2023 – ARVADA, COLORADO, We are excited to announce that RT Welter and Associates, Inc. has outgrown its former name and proudly announces its new name: Welter Healthcare Partners.

Our organization was started over 30 years ago by Founder Todd Welter. With Todd’s leadership, we have continuously expanded in scale, capabilities, and client partnerships. Today, we are led by a seasoned executive team overseeing client ROI, daily operations, and customer service, who are now guided and supported by Todd’s new role as our visionary CEO/Chairman.

We adopted a new name that truly embodies who we are today: a team of staff partners providing exceptional customer service and attention to detail for our client partners – a true partnership in success.

We are pleased to announce that effective July 1, 2023, RT Welter and Associates, Inc. will become Welter Healthcare Partners.

For inquiries please contact Jen Heuer at info@welterhp.com

Welter Healthcare Partners
6870 W. 52nd Ave, Ste. 102
Arvada, CO 80002
877-825-8272
welterhp.com

 

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CMS Vaccine Mandate Update: Last, but Not Least, Texas Joins the Rest of the Country

CMS Vaccine Mandate Update: Last, but Not Least, Texas Joins the Rest of the CountrynnTexas is now the last State to determine its vaccine mandate guidelines. The Centers for Medicare and Medicaid Services set forth guidelines, by February 19, 2022, Texas must have its vaccination processes and plans in place, and all covered staff must at least have taken their first dose of a vaccine or have a pending exemption request to be in compliance with the CMS rule. By March 21, 2022, all covered staff must be fully vaccinated against COVID-19 or have received an exemption to be in compliance with the CMS rule. Continue reading below to learn more. nn nOn January 13, 2022, the Supreme Court of the United States issued an opinion staying preliminary injunctions issued in cases filed in Missouri and Louisiana challenging the Centers for Medicare and Medicaid Services (CMS) COVID-19 vaccination mandate for healthcare providers. The ruling stayed preliminary injunctions applicable to twenty-four states. Twenty-five states were already subject to enforcement under the CMS rule. This left Texas standing alone and in limbo.nn nnDismissal of the Texas CasennOn January 14, 2022, CMS filed in the U.S. District Court for the Northern District of Texas a motion to stay the preliminary injunction applies to the State of Texas, pending the resolution of an interlocutory appeal that CMS filed with the U.S. Court of Appeals for the Fifth Circuit on the same day. The district court ordered the State of Texas to file its response to CMS’s motion by January 18, 2022.nnOn January 18, 2022, the State of Texas filed a motion to dismiss the case without prejudice. It also filed a response to CMS’s motion for stay, arguing that it was moot because Texas sought to dismiss the case.nnCMS filed a reply memorandum on January 19, 2022, arguing that its motion to stay was not moot until the case was dismissed and requesting that the court either grant its motion to stay or dismiss the case by 5:00 p.m. on January 19, 2022.nnThe district court issued an order dismissing the lawsuit without prejudice on January 19, 2022, allowing CMS to enforce the vaccine mandate nationwide.nn nnNew CMS Deadlines Applicable to TexasnnOn January 20, 2022, CMS issued new guidance setting forth the following compliance deadlines for Texas:n

    n

  • By February 19, 2022, covered facilities in Texas must have their vaccination processes and plans in place, and all covered staff must at least have taken their first dose of a vaccine or have a pending exemption request to be in compliance with the CMS rule.
  • n

  • By March 21, 2022, all covered staff must be fully vaccinated against COVID-19 or have received an exemption to be in compliance with the CMS rule.nAll prior deadlines set for the other forty-nine states remain unchanged.
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n nnTakeawaysnnCovered facilities in Texas may want to consider dusting off their vaccination processes and plans and restarting the implementation process if they have not already done so. With Texas’s state vaccine executive order in conflict with the CMS rule, Texas employers may also want to ensure their policies make clear that their CMS-compliant policies apply to CMS-covered facilities and preempt the executive order. On the other hand, for any employee not working in a CMS-covered facility, another policy and/or the provisions of the executive order may apply to them.nnOgletree Deakins will continue to monitor and report on developments with respect to the COVID-19 pandemic and will post updates in the firm’s Coronavirus (COVID-19) Resource Center as additional information becomes available. Important information for employers is also available via the firm’s webinar and podcast programs.nnOriginal article published on ogletree.com

CMS Proposed Bi-Annual ICD-10 Implementation Dates

CMS Proposes Bi-Annual ICD-10 Implementation DatesCMS proposed bi-annual ICD-10 implementation dates that would be in addition to previous coding from last October. With the ongoing COVID-19 pandemic, the industry has had to adapt and evolve quickly. Of course, with new coding comes new standards for the medical industry. Read more below to see the new CMS proposed bi-annual coding dates. nnIn the March 2021 virtual ICD-10 Coordination and Maintenance Committee meeting, the Centers for Disease Control and Prevention’s National Center of Health Statistics (CDC/NCHS) and the Centers for Medicare and Medicaid Services (CMS), announced a new proposal to introduce an April 1st implementation date for ICD-10-CM & ICD-10-PCS updates. This April 1 implementation would be in addition to our existing October 1 implementation for code set updates and revisions, and would be considered under Social Security Act section 1886(d)(5)(K)(vii).nnThis proposal is, in part, due to lessons learned from the ongoing COVID-19 Public Health Emergency (PHE) and the need for the healthcare industry to adapt quickly to rapidly evolving industry standards and the impact it has on the business of medicine. The Committee concluded with a call for public comments on this proposal. All comments must be submitted by May 7, 2021 to CMS at ICDProcedureCodeRequest@cms.hhs.gov.n

To learn about the pros and cons of the proposed bi-annual ICD-10 implementation dates, please click here.

House has Delayed Medicare Sequester Cuts Through 2021

House has Delayed Medicare Sequester Cuts Through 2021The house has delayed Medicare 2% sequester cuts through 2021. Sequestration cuts were originally supposed to be implemented this month, however, Congress has acknowledged how detrimental this may be to providers and patients and this has ultimately prompted the extension. Continue reading below to find out more.nnPresident Biden is expected to sign the bill, which has already cleared the Senate.nnKey Takeaways:n

    n

  • To pay for the estimated $18 billion in delayed cuts, the bill increases the fiscal year 2030 sequester cuts.
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  • The bill also tweaks the rural health clinic provisions in the Consolidated Appropriations Act, 2021.
  • n

  • Specifically, requirement that the payment rate for RHCs be capped at $100 per visit beginning April 1, 2021.
  • n

  • The rate will increase gradually based on the Medicare Economic Index, but the AHA said it will remain well below typical provider-based RHC rates.
  • n

  • Medicare also faces a separate 4% cut — about $36 billion — owing to the Pay-as-You-Go provisions that kicked in to offset the cost of the American Rescue Plan Act.
  • n

  • The House had already passed a bill eliminating PAYGO for the stimulus bill, but the Senate did not act on it.
  • n

nA bipartisan U.S. House on Tuesday night voted 384-38 to delay until the end of 2021 Medicare’s reviled 2% across-the-board sequestration cuts that were supposed to take effect on April 1. The Senate passed the bill 90-2 last month and President Joseph R. Biden is expected to sign it in the coming days. To pay for the estimated $18 billion in delayed cuts, the bill increases the fiscal year 2030 sequester cuts. American Medical Association President Susan R. Bailey, MD, said the overwhelming support in Congress for delaying the cuts “acknowledges that cutting Medicare payments during a pandemic is ill-conceived policy.”nn”Physician practices are already distressed, and arbitrary 2% across-the-board Medicare cuts would have been devastating,” she said. Rick Pollack, president and CEO of the American Hospital Association, said the delay was needed while hospitals and clinicians contend with the coronavirus pandemic and ongoing vaccination efforts. “Even though our country is making great progress by vaccinating millions of people a day, it is clear that this pandemic is far from over and that there is an urgent need to keep hospitals, health systems, and our heroic caregivers strong,” Pollack said.nnAnders Gilberg, senior vice president, government affairs, at the Medical Group Management Association, said his association was “relieved that Congress heeded our call to protect medical groups from the arbitrary 2% Medicare sequester cuts through the end of 2021.” “MGMA has long opposed the sequester cuts, a tax that penalizes medical practices for Congress’ inability to meaningfully address the country’s budgetary affairs,” Gilberg said. “To reinstate the Medicare sequester in the middle of a global pandemic would threaten the viability of physician practices and adversely impact the patients they treat.”nnWith the extension in place, Gilberg urged Congress “to work in a bipartisan manner to expeditiously pass legislation that would prevent an additional 4% Medicare spending cut next year due to the budgetary effects of the American Rescue Plan.” The bill also tweaks the rural health clinic provisions in the Consolidated Appropriations Act, 2021. Specifically, the requirement that the payment rate for RHCs be capped at $100 per visit beginning April 1, 2021. The rate will increase gradually based on the Medicare Economic Index, but the AHA said it will remain well below typical provider-based RHC rates.nnThe bill also includes both Medicare-enrolled RHCs located in a hospital with less than 50 beds and RHCs that have applied for Medicare enrollment as of this date. Medicare also faces a separate 4% cut — about $36 billion — owing to the Pay-as-You-Go mandates that offset the cost of the American Rescue Plan Act. The House had already passed a bill eliminating PAYGO for the stimulus bill, but the Senate did not act on it.nnPollack said the AHA will continue to press Congress and the Biden administration for more “support, resources and tools” for the nation’s hospitals. “This includes continuing to advocate for more overall funding for the Provider Relief Fund, relief for hospitals and health systems with Medicare accelerated payments, hospital and health system priorities to be included in the upcoming infrastructure legislative package and Congressional action by the end of the year on Medicare cuts due to the effects of PAYGO,” he said.nn“To reinstate the medicare sequester in the middle of a global pandemic would threaten the viability of physician practices and adversely impact the patients they treat.”n-Anders Gilberg, MGMA nnOriginal article published on healthleadersmedia.com

CMS Pauses Claim Payments Until Congress Passes Sequester Fix

CMS Pauses Claim Payments Until Congress Passes Sequester FixCMS pauses payment claims submitted after April 1st until Congress passes the sequester bill. As ideas of the sequester extension have been thrown around, CMS has paused payments to minimize the volume of claims that would be reprocessed. More news should come out soon as Congress returns from recess. Read below to find more about CMS updates. nnThe House is on recess but expected to pass the bill when it returns to Washington, D.C., on April 13. A version of this article was first published April 5, 2021, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders. CMS is holding payments for claims submitted on or after April 1 in anticipation of legislation that will extend the suspension of a 2% cut (sequester) to all Medicare payments, according to a special edition of MLN Connects.nnThe Senate recently passed a bill that would eliminate the 2% sequestration of Medicare reimbursements through the end of 2021. The House is on recess but expected to pass the bill when it returns to Washington, D.C., on April 13. According to CMS, temporarily withholding payments will “minimize the volume of claims the MACs [Medicare Administrative Contractors] must reprocess if Congress extends the suspension.” MACs will reprocess any claims paid with the reduction applied, if necessary.nnExtension of the sequester is a major priority for the American Medical Association, American Hospital Association, and other physician groups who believe the 2% payment cut would financially devastate already distressed physician practices. Revenue Cycle Advisor combines all of HCPro’s Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly.nnOriginal article published on healthleadersmedia.com

AMA Releases 2021 Guideline UPDATE

AMA Releases 2021 Guideline UPDATEThe AMA has released new 2021 guidelines for E/M clarifications and we have the updates for the new corrections. Stay up-to-date and informed with WHP about new changes in guidelines in coding for E/M. Continue reading below to learn more.nnMarch 9, 2021 – American Medical Association (AMA) released an update to the 2021 Evaluation and Management (E&M) guidelines with clarification of definitions within the previously released guidelines. These updates, although vast, appear to really focus on the Data elements of our Medical Decision Making (MDM).nnThe updated guidelines list the following revisions.n

    n

  • Clarifying when reporting a test that is considered, but not selected after shared decision making.
  • n

  • Providing a definition of “Analyzed” for reporting tests in the data column.
  • n

  • Clarifying the definition of a “unique” test.
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  • Clarifying what is meant by “discussion” between physicians, and other qualified health care professionals and patients.
  • n

  • Providing a definition of major vs minor surgery
  • n

Celebrating National Doctor’s Day 2021

Celebrating National Doctor's Day 2021This year, we celebrate National Doctor’s Day by recognizing all the hard work and sacrifices during the COVID-19 pandemic of 2020 and 2021. Doctor’s hard work and selflessness have made the biggest differences in our communities as we overcome the hardships of the past year. From frontline work to research, doctors have been working hard to keep our communities safe and healthy.nnFor this National Doctor’s Day, keep in mind the ways doctors have impacted you and how much doctors mean to our society. While 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!

AMA Released 2021 Updates for E&M

AMA Released 2021 Updates for E&MThe AMA has released new updates for the 2021 Evaluation and Management guidelines. Stay up to date with the newest guidelines and AMA definition clarifications. Welter Healthcare Partners will also be hosting a webinar to review these changes with a link and sign-up available. Read more below to learn more. nnMarch 9,2021 – American Medical Association (AMA) released an update to the 2021 Evaluation and Management (E&M) guidelines with clarification of definitions within the previously released guidelines. These updates, although vast, appear to really focus in on the Data elements of our Medical Decision Making (MDM).nnThe updated guidelines list the following revisions.n

    n

  • Clarifying when reporting a test that is considered, but not selected after shared decision making.
  • n

  • Providing a definition of “Analyzed” for reporting tests in the data column.
  • n

  • Clarifying the definition of a “unique” test.
  • n

  • Clarifying what is meant by “discussion” between physicians, and other qualified health care professionals and patients.
  • n

  • Providing a definition of major vs minor surgery.
  • n

n Welter Healthcare Partners will be hosting one more webinar to review these changes and provide examples of when these changes will be relevant to your practice.

Burnout and How it Has Affected Us

Burnout and How it Has Affected UsBurnout has been the reality for millions of people this past year. Whether it is a change in lifestyle or working too much, it can change the way we approach and do things in our everyday lives. What is burnout exactly and how can we approach these emotions going forward? Read below to learn more.nnHow are you doing? This simple question gets asked a lot these days, and for some of us our standard answer is “ok”. We are asked this at work, by friends, by family, and even strangers in limited interactions while at the grocery store. But what does it really mean? Does the person asking us really care? When it comes to our work life, are we truly aware of how we are doing? Burnout is nothing new.nnWorld Health Organization (WHO) defines burnout as an occupational phenomenon.nIt is included in ICD-10 and identified by code Z73.0. With the release of ICD-11, Burnout received a more detailed definition.nnAccording to the WHO’s website, Burnout is characterized by three dimensions:n1) feelings of energy depletion or exhaustion.n2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job.n3) reduced professional efficacy.nnPersonally, this is not something I ever thought about. Until I listened to a recent episode of NPR’s Life Kit, host Rhitu Chatterjee spoke with professionals regarding burnout and how it affected them personally and psychiatrist on ways to cope with this in your own lives.

Webinar Training – 2021 E/M TECHNICAL CORRECTIONS Just Released!

Webinar Training – 2021 E/M TECHNICAL CORRECTIONS Just Released!The webinar training has been announced for the 2021 E/M technical corrections! Join Welter Healthcare Partners in a webinar training event to go over the newest changes in E/M guidelines and stay up to date on the newest coding changes. Check below for times and dates for the upcoming webinar training and register your practice/organization! nnBy Ginger Avery, CPC, CPMA, CRC nMarch 17, 2021nnSince the release of the January 1, 2021 updated E/M guidelines for office or other outpatient (CPT codes 99202-99215) and prolonged services (CPT codes 99354, 99355, 99356, 99417), the AMA has received an abundance of feedback from clinicians on areas of confusion. The AMA’s CPT Editorial Panel has made several technical corrections to add clarity to these exciting updates. These technical corrections were released March 9th and are effective January 1, 2021.nnThe summary of updates listed below reveals that most of the new information is concentrated on medical decision making (MDM) definitions:nn

    n

  1. Total Encounter Time Reporting: Clarification has been made when to NOT count time. 
  2. n

  3. Five new MDM definitions added:n
      n

    1. Analyzed – referred to in the data element of Table 2 of the guidelines
    2. n

    3. Combination of data elements
    4. n

    5. Discussion
    6. n

    7. Unique Test and Unique Source
    8. n

    9. Surgery: minor vs. major
    10. n

    n

  4. n

  5. Revised Definitions have been created to clarify the following terms:n
      n

    1. Drug therapy requiring intensive monitoring for toxicity
    2. n

    3. Independent Historian
    4. n

    5. Risk
    6. n

    7. Test
    8. n

    n

  6. n

  7. Clarification provided for separately reported tests and interpretation. 
  8. n

nMake sure your organization is up-to-date with these recent revisions and has a solid understanding of the new 2021 E/M Guidelines for office visit services. These monumental changes cannot go unnoticed! Register below for a one-hour webinar presented by Welter Healthcare Partners on these crucial updates. If you have any submission issues with the contact form, please email Cody at cwhitworth@rtwelter.com to register. nnAll webinar registrants will receive 5 of Welter Healthcare Partners’s 2021 Office Visit E/M Coding Tools!nn[dt_divider style=”thin” /]nn[gravityform id=”18″ title=”false” description=”false”]nnThese unpredictable updates to our ever-changing healthcare environment should serve as a reminder to visit AMA’s Errata & Technical Corrections regularly for any noted changes.  nn 

Several Technical Corrections Reshape the Recently Released 2021 E/M Guidelines

Several Technical Corrections Reshape the Recently Released 2021 E/M GuidelinesSeveral technical corrections have been made in the recently released 2021 E/M guidelines. With feedback from clinicians to clarify these new guidelines, new summary updates have been presented to clear up any confusion. Stay updated with the clarified E/M guidelines today. Continue reading below to learn more.nnBy Ginger Avery, CPC, CPMA, CRCnMarch 17, 2021nnSince the release of the January 1, 2021, updated E/M guidelines for office or other outpatient (CPT codes 99202-99215) and prolonged services (CPT codes 99354, 99355, 99356, 99417), the AMA has received an abundance of feedback from clinicians on areas of confusion. The AMA’s CPT Editorial Panel has made several technical corrections to add clarity to these exciting updates. These technical corrections were released March 9th and are effective January 1, 2021.nnThe summary of updates listed below reveals that most of the new information is concentrated on medical decision making (MDM) definitions:n

    n

  1. Total Encounter Time Reporting: Clarification has been made when to NOT count time. 
  2. n

  3. Five new MDM definitions added:n
      n

    1. Analyzed – referred to in the data element of Table 2 of the guidelines
    2. n

    3. Combination of data elements
    4. n

    5. Discussion
    6. n

    7. Unique Test and Unique Source
    8. n

    9. Surgery: minor vs. major
    10. n

    n

  4. n

  5. Revised Definitions have been created to clarify the following terms:n
      n

    1. Drug therapy requiring intensive monitoring for toxicity
    2. n

    3. Independent Historian
    4. n

    5. Risk
    6. n

    7. Test
    8. n

    n

  6. n

  7. Clarification provided for separately reported tests and interpretation. 
  8. n

nMake sure your organization is up-to-date with these recent revisions and has a solid understanding of the new 2021 E/M Guidelines for office visit services. These monumental changes cannot go unnoticed! Register below for a one-hour webinar presented by Welter Healthcare Partners on these crucial updates. If you have any submission issues with the contact form, please email Cody at cwhitworth@rtwelter.com to register. nnAll webinar registrants will receive 5 of Welter Healthcare Partners’s 2021 Office Visit E/M Coding Tools!nn[dt_divider style=”thin” /]nn[gravityform id=”18″ title=”false” description=”false”]nnThese unpredictable updates to our ever-changing healthcare environment should serve as a reminder to visit AMA’s Errata & Technical Corrections regularly for any noted changes.  nn 

Bartholin’s Gland Cysts Treatment

Bartholin’s Gland Cysts treatment can come in many different forms. With treatment comes coding for the different classifications and procedures to take care of the cysts. Staying up-to-date with coding can help you organize and get ready for treatment. Continue reading below to learn more!nnBartholin’s glands are two fluid-filled swellings that lubricate the vagina prior to and during sexual intimacy. Due to their size, they can easily become blocked or obstructed by bacteria and cause a cyst or abscess Most Bartholin’s cyst are asymptomatic and resolve on their own. If ancyst does not resolve on its own, it can grow larger, swollen, and painful. nnTreatment options:nnSitz baths and time are usually the first line of treatment. In most instances, the cyst will rupture on it’s own.  However, if conservative treatment does not work, an incision and drainage may be done with a word catheter inserted into the cyst space.  This word catheter is left in place from four to six weeks to help with healing.  Another treatment is surgical marsupialization. The physician will grasp the cyst and create a vertical incision between 1.5 and 3.0 cm long.  This will drain the gland cavity. After that the cyst will be open and the physician will suture the edges of the sit to form a continuous surface from the exterior surface to the interior surface of the cyst. Clinicians also use lasers and injections to treat these cysts. It is also possible to surgically excise the gland or cyst from the vaginal area.  Excision of the cyst is the most invasive treatment option. nnCPT CODING: n

    n

  • 56420:  I&D of Bartholin’s gland abscess
  • n

  • 56440: Marsupialization of Bartholin’s gland cyst
  • n

  • 56740: Excision of Bartholin’s gland cyst.
  • n

nCPT code 56420 is used to report an I&D for a gland that is abscessed. If there was no abscess present, (the cyst was filled with clear fluid), and an I&D was performed, the coder should report one of the following:n

    n

  • 10040: Acne surgery (ie: marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)
  • n

  • 10060: I&D of abscess (ie: carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia), simple or single
  • n

  • 10061: … complicated or multiple
  • n

nCode 56740 is used to report a complete excision.  If the clinician uses a C02 laser or performs a destruction, then report CPT code 56501 (destruction of lesion(s), vulva, simple) or 56515 (…extensive)nnICD 10 CM Coding:n

    n

  • N75.0: cyst of Bartholin’s gland
  • n

  • N75.1: abscess of Bartholin’s gland
  • n

  • N75.8: Other diseases of Bartholin’s gland
  • n

  • N75.9: disease of Bartholin’s gland, unspecified.
  • n

nBe sure to code either a cyst or an abscess. If the clinician notes the presence of bacteria within the abscess, a laboratory code for the specific bacteria can be coded secondary to the abscess code. nn**  AMA CPT 2021nn**  AMA ICD-10-CM 2021nn**  AMA Obstetrics and Gynecology

Biden to Address Mental Health and Addiction Crisis

Biden to Address Mental Health and Addiction CrisisPresident Biden plans to address the mental health and addiction crisis after both have worsened since the start of the pandemic. He plans to split the funding for this endeavor between substance abuse and mental health services. Continue reading below to learn more.nnPresident Biden is directing $2.5 billion in funding to address the nation’s worsening mental illness and addiction crisis, an official from the U.S. Department of Health and Human Services tells Axios.nnWhy it matters: Confronting the mounting mental health and substance abuse crisis will be imperative for the Biden administration, even as its primary focus is on combating the broader COVID-19 pandemic.n

    n

  • The funding announced today is designed to increase access to services for individual Americans.
  • n

  • The funding surge comes as the president has yet to fill several key permanent positions in agencies that would lead the charge in combating the drug epidemic, including the Food and Drug Administration and the White House Office of National Drug Control Policy.
  • n

  • His pick to lead HHS, Xavier Becerra, is expected to be confirmed by a close vote.
  • n

nBetween the lines: The funds will be broken down into two components by the Substance Abuse and Mental Health Services Administration.n

    n

  • $1.65 billion will go toward the Substance Abuse Prevention and Treatment Block Grant, which gives the receiving states and territories money to improve already-existing treatment infrastructure and create or better prevention and treatment programs.
  • n

  • $825 million will be allocated through a Community Mental Health Services Block Grant program, which will be used by the states to deal specifically with mental health treatment services.
  • n

nBy the numbers: A survey conducted last year and published in August 2020 by Centers for Disease Control and Prevention showed that 41% of U.S. adults reported struggling with mental health or substance abuse related to the pandemic or its solutions, like social distancing.n

    n

  • Before the pandemic, over 118,000 people died by suicide and overdose in 2019. An HHS official says the administration is expecting that number to increase because of the COVID-19 pandemic.
  • n

  • Preliminary data out of the CDC indicates that the number of drug overdoses through July 2020 increased by 24% from the year prior.
  • n

nFlashback: On the campaign trail, then-candidate Biden often spoke about the need to address the mounting mental health and substance abuse crisis in America, an issue that hits close to home. His son, Hunter, has openly discussed his own struggles with addiction.nnThe National Suicide Prevention Lifeline (1-800-273-8255) provides 24/7, free and confidential support for anyone in distress, in addition to prevention and crisis resources. Also available for online chat.nnOriginal article posted on axios.com