Archive for the ‘CMS’ Category
CMS and McKesson Continue InterQual Criteria Relationship
McKesson and CMS have announced plans to continue their long-standing relationship with CMS’s adoption of the new version of McKesson’s InterQual Criteria for its Medicare services auditing programs. InterQual products are designed to help assist customers in evaluating an individual patient’s progress through the continuum of care with support for appropriateness of care and related clinical decision-making. Read More »
Computer Assisted Coding: A Critical Step to ICD-10 Readiness
One of the most significant initiatives in recent healthcare history, the ICD-10 is scheduled for adoption on October 1, 2014. The Centers for Medicare & Medicaid Services’ (CMS) has set the deadline to help the US Healthcare system transition into the new code set which is meant to incorporate more specific clinical information and is expected to reduce payment errors and speed reimbursement. However, since the transition is complex and will impact the entire enterprise, it is important to have a strategy in place. Read More »
2013 Radiation Oncology Reimbursement Update
In August MD Buyline reported on the proposed cuts to radiation oncology reimbursement for 2013. With cancer treatment facilities anxiously [...] Read More »
Possible Improved Outcomes Through Data Collection
Longer hospital stays for patients can occur if early detection of a preventable adverse event doesn’t happen. Precursors to an adverse event can [...] Read More »
More Proposed Reimbursement Cuts for Radiation Oncology
It seems that every year the Centers for Medicare & Medicaid Services (CMS) finds additional ways to cut reimbursement for [...] Read More »
3D Parametric Mapping – Worth the Investment?
It’s amazing how far ultrasound has come. First it was 3D, then 4D, and now we have 3D parametric mapping. [...] Read More »
CMS Ruling Equals 11% increase for ICDs
Good news for providers of cardiac resynchronization therapy services! In late 2011 CMS proposed combining APC 0108 (Insertion of Cardioverter-Defibrillator [...] Read More »
Bone Density, a New Way of Thinking in Payment Strategy
Though reimbursement has been stable for a while, the database reflected a 13% increase for bone density (DEXA) buying last [...] Read More »
Making Colonoscopy Pay
I was going through the MD Buyline database and found that endoscopy technology costs have been increasing at a rate [...] Read More »
Bundled Payments Encourage Quality, Savings, and Value
CMS really got my attention with their press release on bundled payments as a method of encouraging quality of care and cost savings. We first saw bundled payments emerge in the last couple of years with imaging studies. Now, CMS Innovation Center will start to phase in the use of bundled payments as a method of encouraging a more efficient approach to managing multiple procedures with a single payment instead of a fee-for-service method of submitting separate bills for each procedure. Read More »