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Medicare Reimbursements: Financial Stability and Change Accompany Mounting Permanent “Doc Fix”

stethoscope-dollar-sign-medicareIt won’t happen all at once, but the impact on how providers are paid by Medicare is taking on an accountable care structure based on Congressional legislation poised to finally end nearly 20 years of balanced budget distress via the failed Medicare Sustainable Growth Rate (SGR) formula begun in 1997.

The U.S. House on March 26 passed a bill to establish a permanent fix to Medicare reimbursements and avoid the history of pay cut threats and funding patches. The Senate is prepared to take up the bill in mid-April after the Easter recess. Senate leaders predict it will pass there and the Obama administration has already announced it will sign the bill.

Given the technical funding cut deadline of March 31, and as to whether providers will experience a 21-percent cut in the meantime, the Centers for Medicare & Medicaid Services (CMS) noted in an email March 27 that electronic claims are not paid until at least 14 calendar days after they are received, providing something of a cushion before doctors may feel any short-term cut. This could allow enough time for the bill to become law, but we will be watching for any updates.

How the new system will pay

The overall provisions mirror last year’s delayed legislation and seek to establish annual payment increases and phase out fee-for-service reimbursements in lieu of a provider scoring system based on several aspects of quality reporting. The process would bundle meaningful use (MU), the Physician Quality Reporting System (PQRS) and value-based modifier (VBM) reporting and end those specific payment adjustments, though other adjustments would replace them along with a financial risk factor similar to those in CMS accountable care organizations (ACOs).

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HIMSS 2015: How to get connected during the conference

HIMSS-15-Greenway-HealthAs an event that brings together 38,000 healthcare IT professionals, clinicians and vendors, it’s no surprise that the annual HIMSS conference can be a bit intimidating.

To make sure you have the best experience possible in 2015, here are a few tips for getting connected — to your peers, educational opportunities and fun — during this year’s conference.

Before the show

Don’t wait until you’ve arrived at the conference to decide which of the 300-plus educational sessions to attend. Make your game plan well before the event begins.

Is there a specific challenge your practice is facing? Do you want to reinforce your existing knowledge or explore new domains? Once you know your areas of interest, you can find sessions that are tailored to you.

Here are some of the sessions and booths we recommend:

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How practices can create another revenue stream without Medicare, Medicaid or private insurance

Marketplace-Blog-Update-MarchCaring for your patients is your top priority, of course, but keeping your practice financially healthy is also vital to your success — and that’s becoming harder than ever.

With impending cuts to Medicare and Medicaid reimbursements, physicians and clinics must find new sources of revenue to sustain their practices.

Some physicians have moved entirely to a business model of concierge medicine — essentially, charging patients an annual fee or retainer for constant provider access — but this transition isn’t an easy one.

A more moderate option is to participate in the quickly growing practice of pretrial evaluations.

Pretrial evaluation is the process of prescreening patients for phase II and III clinical trials that address chronic diseases, then referring those patients to trial sites. Independent third parties compensate participating physicians for conducting the evaluations.

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Is Your OB-GYN Practice Ready for the Future of Healthcare? [QUIZ]

OB-GYN-Medicine-Is-Evolving-Fast-blog-featured-imageWhere do you see your OB-GYN practice in 10 years?

You may not be able to see into the future, but your answer to this question can provide valuable insight into the lasting success of your practice.

In healthcare, change is inevitable. Technology and the evolution of medicine isn’t something that’s likely to slow down. And if your practice isn’t on track to adopt and adapt the emerging technology, incentive programs and reimbursement models, your organization may miss out on significant benefits.

“I’ll admit that I was probably the most resistant physician of any at our practice to go from paper to electronic,” said Dr. Cathy Slusher from Harrisonburg OB-GYN Associates. “It took a little while to convince me, but a year into it, it was clear that there was an advantage.”

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Patient engagement: How to get patients to use your portal

Greenway Health Patient PortalWe’ve all heard about the promise of the patient portal: Give patients convenient online access to personal health information and support care between visits, and they’ll better manage their own health.

Providers benefit, too. A patient portal can improve the quality of care and office efficiency, not to mention help practices achieve meaningful use.

But before practices can see the advantages of a portal, they have to get their patients to use it.

Many practices admit that they struggle with getting their patients to access and view their online health records. Despite the challenges, it can be done, according to a few providers who have successfully driven patient engagement within their own practices via a patient portal.

The key, they explain, comes down to making sure patients are aware of the fundamentals: features and convenience.

Create a scenario patients can see themselves in

“The easier we make a portal to use for the patient, the more they’re going to engage in their healthcare,” said Michael Popp of MJP Healthcare Consulting.

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The best way to deal with changes in healthcare? Practice patience.

Patience-is-key-healthcare-changesWorking in healthcare today can sometimes feel like you’re caught in the classic tale of the tortoise and the hare, in which industry changes move at a speed much faster than providers, practices and health IT partners could possibly maintain.

As a solo practitioner responsible for both patient care and keeping up with the constant regulatory changes, Dr. Scott Maurer knows this struggle well. He maintains that the key to success is simple, even if it doesn’t always come easy. It’s all about patience.

The challenge of change for providers, IT partners

Healthcare changes constantly. Regulations shift, reporting requirements expand and the list of healthcare terms grows daily.

“There are about 30 different acronyms that I’ve had to learn: PQRS, MU, ARRA — and it goes on and on,” Dr. Maurer said. “It’s a very challenging environment with so many things changing in healthcare. I’m trying to stay abreast of all the developments, but it’s not so easy when you’re busy as a physician practicing every day.”

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