Leah Houston, MD’s Post

inVio Health Network and CVS Accountable Care Partner to Improve Medicare Patient Care in South Carolina - HIT Consultant #inVioHealthNetwork and #CVS Accountable Care have partnered to enhance Medicare patient care in South Carolina through an Accountable Care Organization (#ACO). The collaboration aims to improve patient outcomes, reduce costs, and enhance care coordination for Medicare beneficiaries in the state. The partnership will leverage technology and data analytics to identify high-risk patients, implement care management strategies, and drive better health outcomes. This initiative demonstrates the growing trend of healthcare organizations working together to deliver more efficient and effective care to patients, particularly those with complex healthcare needs. #MedicarePatientCare #SouthCarolina #HealthcareCollaboration #DataAnalytics #CareCoordination. ai.mediformatica.com #health #network #healthcare #medicare #accountablecare #collaboration #this #patientcare #medicarebeneficiaries #mssp #populationhealthmanagement #prisma #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/442fYPO)

Sharing a terrific article from Health Affairs describing the history and evolution of the Physician Fee Schedule and why it is an overlooked and under-appreciated tool in the toolbox to help address payment distortions in US Health care. The authors argue that for all our efforts at value-based payments, we've failed to utilize all the tools at our disposal - principally the physician fee schedule that drives reimbursement for the majority of professional services in healthcare. The physician fee schedule is the ultimate reflection of the US healthcare value-system and despite a decade of talk about the #tripleaim and #valuebasedcare very little has changed in the physician fee schedule to reflect a shift toward preventive, team-based, comprehensive care. https://lnkd.in/edC3sats

🚀 Breaking News: CMS Releases 2025 Proposed Physician Fee Schedule!🚀 Healthcare professionals, it's time to gear up for significant changes! The Centers for Medicare & Medicaid Services (CMS) has just released the 2025 Proposed Physician Fee Schedule, and it's packed with updates that could impact your practice's revenue cycle and patient care. What's New? 📈 Updated Payment Rates: Adjustments that could affect your bottom line. 📊 Telehealth Services: Continued expansion and what it means for remote care. 🏥 Evaluation and Management (E/M) Changes: Streamlining and clarifications for better compliance. 🌐 Quality Payment Program: Enhancements to promote value-based care. Why It Matters? These changes will shape the way you deliver care and how you get reimbursed. Understanding and preparing for these updates is crucial to stay ahead in the evolving healthcare landscape. Stay Informed! Make sure to review the proposed rule and submit your comments. Engage in the conversation to ensure your voice is heard. ♻️ Repost to help someone.  🔔 Follow the page for daily posts on HealthCare Regulatory Compliance. #CMS2025 #HealthcareUpdates #PhysicianFeeSchedule #Telehealth #ValueBasedCare #HealthcareCompliance #MedicalBilling #Medicare

📢 Exciting News! 📢 The American Telemedicine Association (ATA) and ATA Action are committed to thoroughly reviewing the 2025 Physician Fee Schedule (PFS) and Outpatient Prospective Payment System (OPPS) proposed rules released by the Centers for Medicare & Medicaid Services earlier this afternoon. Our goal is to ensure telehealth remains a cornerstone of modern healthcare. As I mentioned in our press release, "We are eager to work with CMS and the Biden administration on the draft rule to ensure that telehealth remains a cornerstone of modern healthcare. Our extensive, broad-based ATA and ATA Action community will be offering thorough comments to ensure that the proposed policies support sustainable, high-quality healthcare delivery." The urgency for Congress to act on extending or making permanent the pandemic-era telehealth flexibilities in the Medicare program cannot be overstated. With a bipartisan consensus, now is the time to act to maintain the progress we have made. Read our full press release below for more details on this important development and our ongoing advocacy efforts. Let's continue to advance telehealth and ensure accessible, high-quality care for all! #Telehealth #HealthcareInnovation #ATAAction #PublicPolicy #Medicare #CMS

How many Medicare patients are on Remote Patient Monitoring? In case you didn't know, the Centers for Medicare & Medicaid Services publishes a Part B HCPCS-level summary file every September [1]. Since it's September, we just loaded the latest data, which is from 2022. The chart below shows all the Remote Patient Monitoring (RPM) CPT codes: 99453/4/7/8 by year. Many RPM start-ups have been formed during those years, and I became curious about how many patients were on RPM then. One easy way to track the number of RPM patients is to track 99453—the onboarding code. This onboarding code is used only once per patient (in theory), so the sum of these codes would approximate the total number of RPM patients. 2019: 20,640 2020: 90,149 2021: 123,476 2022: 164,634 So, by the end of 2022, approximately 398,899 patients have tried RPM while on Medicare. Considering 35+M Medicare FFS members, 400K members seem weirdly small, barely above 1%. I am curious how many patients have tried RPM so far in 2024. Do you think it reached at least 2% [1] https://lnkd.in/eCTenNdJ #remotepatientmonitoring #healthcaredata #opendata #virtualcare #telehealth

Measuring patient outcomes is one way to determine the effectiveness of interventions in the care setting. As healthcare in the United States transitions from a fee-for-service to a value-based care model, the Merit-Based Incentive Payment System (MIPS) determines Medicare payout for clinicians and practices based on reporting measures. According to the Centers for Medicare and Medicaid Services (CMS), "MIPS was designed to tie payments to quality and cost-efficient care, drive improvement in care processes and health outcomes, increase the use of healthcare information, and reduce the cost of care." What does that mean for clinicians? Clinicians who participate in Medicare Part B and who are eligible (and required) to participate in MIPS receive an annual score based on a 100-point performance system. The score is comprised of the following categories: • Quality (30%) • Promoting Interoperability (25%) • Improvement Activities (15%) • Cost (30%) Based on the total score, the clinician or practice may be eligible for a positive payment adjustment or up to a 9% reimbursement decrease. Implementing a Chronic Care Management (CCM) program can improve a MIPS score, particularly through the use of quality and improvement activities. By identifying patients who are non-compliant with quality measures, clinicians and practices can utilize CCM to make meaningful advancements in patient care while improving reimbursement rates. Interested in learning how CCM can improve quality and reimbursement in your practice? Contact us at ccm@medaligninnovativesolutions.com for a complimentary consultation. Source: https://lnkd.in/gnnP6rDZ #chroniccaremanagement #remotepatientmonitoring #principalcaremanagement #caremanagement #qualityhealthcare #qualityimprovement #healthcare #ccm #rpm #pcm #patientcenteredcare #valuebasedcare #nurseledchange #makinghealthcarebetter #medalign #MIPS #QPP #primarycare #MIPS2024

Measuring patient outcomes is one way to determine the effectiveness of interventions in the care setting. As healthcare in the United States transitions from a fee-for-service to a value-based care model, the Merit-Based Incentive Payment System (MIPS) determines Medicare payout for clinicians and practices based on reporting measures. According to the Centers for Medicare and Medicaid Services (CMS), "MIPS was designed to tie payments to quality and cost-efficient care, drive improvement in care processes and health outcomes, increase the use of healthcare information, and reduce the cost of care." What does that mean for clinicians? Clinicians who participate in Medicare Part B and who are eligible (and required) to participate in MIPS receive an annual score based on a 100-point performance system. The score is comprised of the following categories: • Quality (30%) • Promoting Interoperability (25%) • Improvement Activities (15%) • Cost (30%) Based on the total score, the clinician or practice may be eligible for a positive payment adjustment or up to a 9% reimbursement decrease. Implementing a Chronic Care Management (CCM) program can improve a MIPS score, particularly through the use of quality and improvement activities. By identifying patients who are non-compliant with quality measures, clinicians and practices can utilize CCM to make meaningful advancements in patient care while improving reimbursement rates. Interested in learning how CCM can improve quality and reimbursement in your practice? Contact us at ccm@medaligninnovativesolutions.com for a complimentary consultation. Source: https://lnkd.in/gnnP6rDZ #chroniccaremanagement #remotepatientmonitoring #principalcaremanagement #caremanagement #qualityhealthcare #qualityimprovement #healthcare #ccm #rpm #pcm #patientcenteredcare #valuebasedcare #nurseledchange #makinghealthcarebetter #medalign #MIPS #QPP #primarycare #MIPS2024

Ready to rock 2024? Know the REAL Health Providers Act inside out! 💡 Get all the details on the 👉proposed provider directory accuracy requirements👈 for Medicare Advantage Organizations in our blog post. https://okt.to/vULn1A #QuestForSuccess #MedicareAdvantage #HealthPolicy

News from First Report Managed Care: The current Medicare Physician Fee Schedule brought many significant changes to increase access to much needed virtual care management (VCM) services to underserved populations. Learn more about the potential implications of these fee changes from an expert in this interview with Brian Esterly. #FirstReportManagedCare #FRMC #medicarephysicianfeeschedule #medicare #virtualcaremanagement #VCM

Ohio State & CVS Form ACO to Elevate Medicare Care in Central Ohio - HIT Consultant #OhioState & #CVS Form ACO to Elevate Medicare Care in Central Ohio Ohio State University Wexner Medical Center and CVS Health have formed an Accountable Care Organization (ACO) to improve healthcare outcomes for Medicare beneficiaries in Central Ohio. This collaboration aims to enhance care coordination, increase access to healthcare services, and improve the overall patient experience. #ACO Model and Medicare The ACO model is a value-based care approach that focuses on improving quality and reducing costs for Medicare beneficiaries. ACOs are groups of healthcare providers who work together to coordinate care and share accountability for the quality and cost of healthcare services. This model aligns with Medicare's goal of transitioning from fee-for-service to value-based care. #Benefits of ai.mediformatica.com #medical #accountablecare #this #health #medicare #medicarebeneficiaries #patientcare #theohiostateuniversitywexnermedicalcenter #chronicconditions #cvshealth #medicaresharedsavingsprogram #mssp #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/3Sc2UC2)