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If the 5 percent bonus payment in the Advanced Alternative Payment Model (APMs) track was available in 2015, accountable care organizations (ACOs) would’ve earned additional net payments of $886 million if they had assumed downside risk under the Medicare Shared Savings Program (MSSP).

Most doctors saw a similar increase in compensation last year as they had in 2015, with an average raise of 2.9 percent across all specialties reported in the American Medical Group Association’s (AMGA) annual medical group compensation and productivity survey. Productivity, however, remained flat, and the move to value-based incentives in compensation continues to be slower than anticipated.

CMS has released its proposed rules for the 2018 Physician Fee Schedule (PFS), Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System, with the biggest change being halving the Medicare reimbursement for off-campus services.

President Donald Trump had proposed a 16 percent cut across HHS in his budget blueprint for fiscal year 2018, but the Republican majority on the House Appropriations Committee added $14.5 billion over his request in its own budget proposal released on July 12.

Jason Considine, senior vice president of patient collections and engagement at Experian Health, argued at the Healthcare Financial Management Association (HFMA) conference in Orlando that providers should first rely on leveraging data and crafting flexible payment options before paying any contingency fees to collectors. He spoke with HealthExec about mistakes providers are making with their collection practices and what data they need to improve the process.

 

Recent Headlines

Clinicians can check 2017 MIPS participation status online

CMS has opened up a new online tool for clinicians to check whether they should participate in the new Merit-based Incentive Payment System (MIPS) for 2017.

Anthem wants 60 more days to fight Cigna’s exit from merger

Anthem has requested more time from a Delaware court to salvage its $54 billion merger with Cigna, asking for a 60-day extension of a temporary injunction to block its would-be partner from opting out of the deal. 

Billing patients at chargemaster rates may be illegal

Charging patients at the list prices for procedures and services set by the hospital chargemaster isn’t allowed under contract law, according to a study published in American Journal of Managed Care.

Siemens Healthineers looking at several separation options

Siemens is moving ahead with the planned split of its healthcare division, Siemens Healthineers, with CFO Ralf Thomas listing three options for the $15 billion business: a spinoff, an initial public offering or a reverse merger with a public company.

Anthem wants Supreme Court to review blocked Cigna deal

Anthem is taking its blocked $54 billion acquisition of Cigna to the U.S. Supreme Court, asking the highest court to review the rejection by a federal appeals court.

Q&A: AAFP's alternative payment model focuses on primary care

American Academy of Family Physicians (AAFP) President John Meigs Jr., MD, took a deeper dive with HealthExec into the new model, titled the Advanced Primary Care Alternative Payment Model (APC-APM), including what current APMs inspired its components and how it could help smaller primary care practices qualify for the 5 percent APM bonus.  

New Jersey’s Hackensack Meridian, JFK Health agree to merge

Hackensack Merdian Health would grow to a 15-hospital system in northern and central New Jersey under its new merger agreement with JFK Health.

1,600 Brigham and Women’s employees offered voluntary buyouts

Brigham and Women’s Hospital in Boston has presented 1,600 employees—nearly 9 percent of its workforce—with the option of a voluntary buyout as the hospital looks to cut costs.

CMS: Expect MIPS eligibility notices in next month

Clinicians should soon be receiving notices on whether they’ll be required to participate in the new Merit-based Incentive Payment System (MIPS), CMS said in a notice issued on April 25.

Express Scripts likely to lose Anthem, its biggest customer

Pharmacy benefits manager Express Scripts said it will lose Anthem as a client when its current contract expires at the end of 2019, claiming it can’t agree to the price concessions Anthem has been demanding.

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