Cost For Doc Services Lag Behind Inflation

Physicians have long felt that the cost of running a practice is growing more quickly than payment received per service.

According to Bureau of Labor Statistics (BLS) data released earlier this month, the Consumer Price Index (CPI) for all items went up 0.3% in March and 2.7% in the previous 12 months. Prices paid for physician care, which includes the amount from an insurer as well as the patient portion for a single service, went up 0.2% for the month and 1.3% during the past year.

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Technology Key To Population Health Management

According to a report unveiled by the Institute for Health Technology Transformation (iHT2) earlier this week, technology will become more indispensable as healthcare shifts to an Accountable Care Model.

The report, Population Health Management: A Roadmap for Provider-based Automation in a New Era of Healthcare, details the ways in which providers must embrace technology and leverage it for increased efficiencies and improved outcomes.

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Physicians Fight Medicare Overpayment Rule

Organized medicine is pushing back against a Medicare proposal to recoup overpayments quickly from physicians, who would be required to go back through up to 10 years of medical records when determining if they received excess pay.

The American Medical Association (AMA) and state and specialty medical organizations have called on the Centers for Medicare & Medicaid Services (CMS) to clarify new requirements that practices must return overpayments within 60 days.  Earlier this month, about 110 groups, led by the AMA, sent a letter to CMS acting Administrator Marilyn Tavenner calling on the agency to make necessary changes before the proposal is finalized.

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Meaningful Use Monday: Don’t Leave Money On The Table

Electronic Health Record (EHR) stimulus checks are now in the mail for those who have already become meaningful users of a certified EHR. More than 2,000 hospitals and 41,000 doctors have already received $3.1 billion in incentive payments for ensuring meaningful use.  Now, it’s your turn!

Don’t miss out on the stimulus money available to you!  Contact HMS Healthcare Management Solutions 1 888-629-6664 today and find out about our fully integrated, affordable, cloud-based EHR solutions today!

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Speculation As Supreme Court Mulls Healthcare

This week the U.S. Supreme Court wrapped up the last oral arguments of its current term. Now comes the nationwide angst of waiting – as long as two months – for decisions, particularly the one that will resolve the most high-stakes and closely watched case of the year: the challenge to the Obama-sponsored healthcare law.

News outlets, including this one, are fielding tips from would-be sources who claim they know somebody who knows something about action on particular legal issues, a possible vote split, or the supposed date the decision will be published. Even attorneys who practice at the nation’s highest court, who are the first to insist that no one should ever trust the whisper mill, have found themselves looking for signs and portents.

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Growth In Enrollment Driving Medicare, Medicaid Spending

Growth in enrollment, rather than spending per enrollee, will continue to drive Medicare and Medicaid spending growth as aging baby boomers enter Medicare and the Patient Protection and Affordable Care Act (PPACA) extends Medicaid coverage to more uninsured Americans, according to a new report from the Urban Institute.

Medicare enrollment will grow much more than private coverage over the next decade because of the aging baby boomers, while Medicare expenditures per enrollee are expected to increase by only 2.7% per year, largely due to cuts in provider payments included in the PPACA, the report notes. Increases in overall Medicaid spending also will continue to be driven by enrollment growth, largely because of the PPACA.

More Federal Funding for Home-Based Services

States could receive an increased federal Medicaid match if they provide home-based services that allow enrollees to remain in the community rather than be admitted to a hospital or a nursing home, according to a new Patient Protection & Affordable Care Act (PPACA) rule released by the U.S. Department of Health and Human Services (HHS) this week.

Under the Community First Choice Option, states would receive an additional 6% in their federal Medicaid match for participating in the program.  To receive the enhanced funding, states must meet several requirements:

  • create a council for stakeholders to develop their Community First Choice plan
  • set up a quality assurance system;
  • collect data to facilitate a federal evaluation of the program.

States must also maintain their current level of spending for community and home-based services for the first 12 months.  HHS will evaluate the success of Community First Choice plans in 2015.