Partnership to Empower Physician-Led Care’s Post

🌟 Maximize Your MIPS Performance: Unlock Success in Healthcare Practices 🌟 In the evolving landscape of healthcare, mastering the Merit-based Incentive Payment System (MIPS) is more than a regulatory mandate—it's a pathway to enhancing patient care and optimizing practice efficiency. Our insightful blog, "Navigating MIPS: Strategies for Success in Healthcare Practices," demystifies MIPS, offering a treasure trove of actionable strategies to excel in this complex program. 🔑 Key Insights Include: -A comprehensive overview of MIPS and its aim to elevate patient care while managing costs. -Detailed breakdown of the four MIPS performance categories—Quality, Cost, Improvement Activities, and Promoting Interoperability—and their influence on your overall score. -Practical strategies to engage your team in quality improvement, leverage cutting-edge EHR systems, and focus on high-impact measures that align with your practice's strengths. -Essential tips on selecting meaningful improvement activities, monitoring performance data effectively, and steering clear of common pitfalls that can hinder your MIPS success. 💡 Elevate Your Practice: -Discover how to not just meet MIPS standards, but excel, ensuring your practice maximizes reimbursements and sidesteps penalties. -Learn why MIPS should be viewed not as a hurdle, but as a valuable tool for fostering a culture of excellence and continuous improvement in patient care. 🚀 Take the Leap: Embrace MIPS as an opportunity to refine your healthcare practice's quality of care. Dive into our blog for a roadmap to MIPS success, and consider reaching out to NCDS Medical Billing for expert guidance. Together, let's navigate the complexities of MIPS, ensuring a brighter, more efficient future for your practice. 🔗 Explore our blog now and transform your MIPS strategy! https://loom.ly/bSA2XYk #MIPS #HealthcareQuality #PatientCare #MeritBasedIncentive #HealthcareInnovation #NCDSMedicalBilling

Cohere Health announced today a new capability to enhance payer-provider collaboration via Epic’s Payer Platform. Using Cohere’s AI-driven prior authorization solutions, this integration simplifies and expedites prior authorization requests by enabling providers to submit directly in the EHR workflow, thus reducing administrative burden for providers. This in-workflow integration will advance Cohere's ability to automate authorization processes for health plans, while improving care quality and reducing patients' wait times. Read more here: https://lnkd.in/edmc-NYB

As healthcare providers look to move towards value-based care, solutions like PDPM Coach become ever more important to make this goal a reality. @PointClickCare’s PDPM Coach offers an innovative solution to address some of our industry's biggest challenges through real-time insights and fair reimbursement for providers. Through reducing administrative burdens, easing staff turnover, and streamlining certification processes, the solution is a proof point in shaping the future of healthcare management and patient care. 

Hey all! As promised, we've posted a more in-depth article focused on the new Advanced Primary Care Management codes proposed in the 2025 Medicare Physician Fee Schedule Proposed Rule that was released by #CMS last week. (Was it only last week?? Feels like a lifetime ago...) Headlines: * The new monthly APCM codes are NOT based on time spent by practitioners or clinical staff, opening the door for use of AI tech to automate certain care coordination/management functions. * The codes provide a reimbursement opportunity where time requirements for CCM/PCM are not met. * The APCM codes are another step towards preparing primary care physicians for the shift to value-based care -- BUT, proposed reimbursement rates combined with requirements for implementation could hamper adoption. Please share your thoughts in the comments when you have a moment! I also strongly encourage all stakeholders -- vendors of care management services, PCP practices, etc. -- to submit comments to the Proposed Rule by no later than September 9th. We've seen CMS reference specific comments in their Final Rule as reason for changes to their original proposal. We're happy to help! https://lnkd.in/eV4CxPmg

Check out Carrie Nixon's post below on the newly proposed Advanced Primary Care Management Codes from the 2025 Medicare Physician Fee Schedule Proposed Rule! #CMS #caremanagement #digitalhealth #healthcareinnovation

Carefully consider this proposal and tie through related to VBP transitions and AI tools.

PDPM Coach empowers MDS coordinators to ensure accurate diagnosis selection, driving fair reimbursement and operational efficiency. Dr. Steven Buslovich, MD, CMD, MSHCPM explains how the solution enables healthcare providers to move towards a more patient-centric and financially sustainable model by reducing administrative burdens, easing staff turnover, and streamlining certification processes. Read more about how PDPM Coach stands as a testament to our commitment to advancing value-based care principles and shaping the future of healthcare management: https://bit.ly/44yBwDW

Often regulations can be interpreted as inhibiting innovation, but this new CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) (https://lnkd.in/esZz3BuV) is very exciting and will stimulate a surge of new technologies that will benefit patients, providers, and the entire healthcare system.  Working in healthcare technology for the last 20 years, I can see the benefit of this rule which finally anchors the industry in FHIR standards and requires impacted payers to create APIs for patients, providers, and other payers.  It also requires impacted payers to create a standardized, non-drug, prior auth API along with denial reasons which will enable deeper integration into the healthcare team’s workflow and eliminate many inefficiencies. The 10 yr cost of the program is estimated to be $1.2B, mostly shouldered by the impacted payers and the government.  With the AMA’s help, the rule boasts a 10yr $16.5B savings mostly to healthcare provider organizations. In my work as a Family Physician, I know the pains of prior authorization.  A process impeded by paper forms, faxing, phone calls, and tremendous inefficiencies, prior authorization can take many hours to complete and significantly impact patients.  Trying to get a patient their CPAP machine, nebulizer, wheel chair, incontinence supplies, etc. is an ordeal. To realize the $16.5B cost benefit and improved patient care, the provider community must now prepare to use these payer Prior Auth APIs.  If you are interested in how this rule applies to Durable Medical Equipment and the efficiencies that we can leverage through these API’s, please reach out.  If you don't want to read the entire 728 page rule like I did, here is an overview. https://lnkd.in/ePZ89BKn Thanks to WEDI and Dr. Alexandra Mugge CHIO of CMS for a great session. I would also thank the AMA and AMA President Jesse Ehrenfeld MD MPH for their persistence to streamline these inefficient processes in healthcare delivery.  Here is a video describing their involvement. https://lnkd.in/eYQ8AaDW

Developing news for healthcare providers with RPM (Remote Patient Monitoring) regarding advancements and changes to coding. The American Medical Association has proposed changes to coding which could transform reimbursement in 2025. In May, the American Medical Association’s (AMA) CPT Editorial Panel is convening to discuss critical updates and more flexibility to expanding RPM coverage. These changes reflect enhancements to the current four CPT doses and a few proposals: 1. A new billing code covering 2-15 calendar days of collected data, easing billing for shorter RPM monitoring periods. 2. Revising codes to reduce the minimum care management times, creating flexibility on provider reimbursement. 3. Enhancing interactive communication code allowances, encouraging patient engagement. These changes will create higher RPM adoption, flexibility and improve patient outcomes while reducing healthcare expenditures. If approved, Medicare and private payers would likely follow course, a win for our patients and our partners in the RPM industry. For providers interested in pursuing an RPM model, please feel free to reach out to me via email for information on how we can partner. Mauricio Pinto MD MBA FACHE CPE FHM SFHM CEO and Management Partner [email protected] www.justvitalsolutions.com

How value-based care models are impacting billing practices Medical billing is a field that is constantly evolving, with new updates and developments. One such development is value-based care, which is currently transforming the medical billing industry. Value-based care is a provider payment model that prioritizes high-quality healthcare over the quantity of services. The goal of this payment model is to provide better care to patients while reducing the cost of care. https://lnkd.in/exjdSe8T