Care Management Programs Overview:

Beginning in 2013, the Centers for Medicare and Medicaid Services introduced transition of care management (TCM), reimbursing providers for helping their patients with the transition from hospital to home.  Following the introduction of TCM; in 2015 CMS introduced the original chronic care management code, CPT code 99490, to pay providers for delivering non-face-to-face care to Medicare patients with two or more chronic conditions.

In 2017 CMS enhanced the CCM...

MIPS: Find out If You Are in or out for 2018

Finally. The Centers for Medicare & Medicaid Services (CMS) has released an online tool that enables clinicians to determine whether they must participate in the Merit-Based Incentive Payment Program (MIPS) this year. CMS on Friday put out a notice that it has released an updated MIPS Participation Lookup Tool on its web site that will allow clinicians to check on their 2018 eligibility status.

New Payment Model Deserves Quick Approval

In a March 19 letter to HHS Secretary Alex Azar, the AAFP said the Advanced Primary Care Alternative Payment Model would help more than 200,000 primary care physicians promote coordinated care and provide incentives for practices to change the way patient care is delivered.

Dementia Care Spending to Hit $277 Billion

In 2018, the total cost of care for people with Alzheimer’s and other dementias is projected to reach $277 billion. That figure is expected to keep ballooning in coming years and decades, and a growing proportion of spending has been going toward in-home care.

HIMSS18: Care Management and Engagement

Overall, the Chillmark Team was pleased to see progress on telehealth, as well as a broader understanding that healthcare organizations (HCOs) will get patient engagement right only when they assemble a comprehensive collaborative health record (CHR). On the other hand, they were disappointed in slow progress toward addressing two prominent public health issues — the opioid crisis and behavioral health — as we didn’t see many large-scale use cases for...

Top 3 Home Health Care Changes Ahead

After a turbulent year in regulatory proposals for the home health care industry, providers need to be looking to 2018 with fresh eyes on what changes still lie ahead.

CMS Study to Shed Light on MIPS Burden

The CMS is inviting clinicians to participate in a year-long study to assess the burden of reporting under MACRA’s Merit-based Incentive Payment System (MIPS). Participants will need to submit data for at least three measures in the MIPS Quality performance category, including one outcome measure, and take part in a virtual focus group.

Lay-Health Workers Reduce Readmission Rates

A new report from Health Education Research found lay-health workers (LHWs) that addressed social needs affected readmission rates for a high-risk population at a rural community hospital in Kentucky. The study found a nearly 48% relative reduction of 30-day hospital readmissions for those in the program compared to patients that were not part of the program.

Telehealth, Telemedicine Reimbursement Score Big in New Budget Deal

Telehealth and telemedicine reimbursement scored huge successes in the budget deal signed into law by President Donald Trump, with one senator saying the law does more for Medicare coverage of telehealth than any past legislation.

Chronic Care Diagnoses Need Better Patient-Provider Communication

Patient-provider communication following a chronic illness diagnosis needs to strike an important balance of discussing clinical implications and the effect the disease will have on that individual patient’s lifestyle. However, previous patient reports show that providers often miss that mark and that communication can often feel rushed and impersonal, the researchers shared.