Far too often, healthcare organizations treat planning and execution as two separate processes which are intended to achieve a larger goal. Leadership makes plans and departments and workers are told […]
For several years now we’ve had four -X modifiers, generally presented as -X (E, P, S, U) which can be used instead of the -59 modifier to unbundle procedure codes […]
Hierarchical Condition Categories (HCCs) have been the underlying risk adjustment for many Medicare programs for several years. But they didn’t attract wide interest until CMS began shifting more payment toward […]
Value-based payment models are attracting attention for risk adjustment methodologies, especially HCC risk adjustment, which is used to calculate cost benchmarks for Medicare Advantage and other CMS payment models including […]
A recent survey in Healthcare Informatics on physician readiness for implementing MACRA indicates a strong need for assistance and support. The overall results of readiness of physicians polled show that […]
I paraphrase, but this is essentially the question we hear from providers when we talk about ICD-10 coding accuracy.
Happy New Year and thank you to all our readers! Before we officially start 2017, catch up on five of Inside Angle’s most read blogs of 2016: Overcoming skepticism about […]
Have you been leafing through all 2,000+ pages of the Final Rule? Save yourself time and learn how your system can succeed under the new guidelines.
CMS is moving to shift healthcare payments from traditional fee-for-service models to value-based reimbursement (VBR). How prepared is your organization to successfully receive accurate reimbursement for your patient population?
In a recent perspective piece in JAMA Forum, Dr. Ashish Jha of the Harvard School of Public Health argues that increased provider consolidation is threatening the financial viability of the […]
So, this month I am taking a slight detour. Instead of continuing to dissect AHRQ version 6.0 changes, I would like to reflect on providers and quality. I promise to […]
In early October, CMS surprised everyone and published the highly anticipated Final Rule on MACRA well ahead of schedule. A number of blogs have since provided high-level summaries of the […]