Care Management in 2020:

Each year, CMS makes updates to the Medicare care management programs to create more financial reimbursement opportunities for providers and improve the health outcomes of their patients. This year's final rule for the Physician Fee Schedule contains modifications to payment rates, payment policies, and quality provisions. These updates will be officially implemented on January 1, 2020.

TCM Program Updates:

Transitional Care Management focuses on reducing unnecessary...

Strategies for Managing Chronic Conditions in Rural Areas

Chronic diseases disproportionally affect individuals in rural areas. To help manage these and minimize the negative health impacts they have on individuals, local organizations are investing in multiple strategies.

Final Physician Payment Rule Keeps E/M Code Changes

CMS on Friday issued its 2020 final rules for the Physician Fee Schedule, including a streamlining of evaluation and management services (E/M) reporting that was rolled back from an earlier proposal in a change providers applauded.

More Than Half of VBP Hospitals Will See Bonus, Similar to Last Year

In the eighth year of Medicare's Hospital Value-Based Payment Program (VBP), there were more winners than losers, but not much change from the prior year. About 55% of the roughly 2,700 hospitals participating in VBP will receive increased Medicare payments for fiscal 2020.

Waste Gobbles Up 25% of US Healthcare Spending, JAMA Study Finds

The estimated cost of waste in the U.S. healthcare system ranges from $760 billion to $935 billion, or about 25% of the total healthcare spending, according to a report in JAMA issued Monday. 

CMS Care Management Programs - History and Overview:

In 2013, CMS introduced Transition of Care Management (TCM), reimbursing providers for furnishing care to patients transitioning from the hospital to their home. Two years later, the Chronic Care Management (CCM) program was launched to promote better outcomes and reduce the cost of care for patients living with two or more chronic conditions. To expand on the established Annual Wellness Visit (AWV) benefit, CMS introduced Advanced Care...