At HIS, we primarily focus on helping our partners make more money. Whether it is through management of revenue cycle and consulting services, or coding assistance; we help ensure you’re not leaving money on the table. And we do it with an emphasis on Orthopedics and Radiology. Our dedication ensures you’re always getting the most up-to-date, relevant industry information. However, the health industry is much bigger than Orthopedics and Radiology, and changes ripple far beyond their respective industries. Therefore, keeping in step with our dedication to education, I’ve compiled these five need-to-know topics currently in healthcare news.
1. Mandatory Bundling for Joint Replacement
Centers for Medicare and Medicaid Services (CMS) finalized its first mandatory bundled payment initiative. The model, Comprehensive Care for Joint Replacement (CJR), takes effect on April 1, 2016. CJR pertains to lower extremity joint replacements, and is mandatory in 67 markets nationwide. In addition to increasing quality of care and encouraging improved relationships amongst stakeholders, CJR is projected to save Medicare $153 million annually.
2. Cancer Screening Legislation
Multiple states filed initiatives to expand cancer screening options, increasing opportunities for diagnostic imaging for many types of cancer. There was a strong trend for legislation supporting colorectal and breast cancer.
States filing on behalf of colorectal cancer screenings include Florida, Hawaii, Kentucky, Massachusetts, and Michigan. Massachusetts, New Jersey, and New York have filed legislation pertaining to breast cancer screenings and insurance coverage.
3. Value-Based Drug Contracts
A memo recently released by drug maker Eli Lilly and insurer Anthem states both organizations’ support of value-based drug contracts. The pair recommended Congress “create a policy environment conducive to allowing health plans and manufacturers enter into a variety of value-based contracting arrangements.” They specifically listed anti-kickback statuses and government pricing as their major roadblocks.
4. CMS Proposes Structure Changes
CMS’s proposition would alter the parameters used to measure performance of Accountable Care Organizations (ACOs). Currently, ACO performance is measured using national statistics, but the proposed changes would allow for the use of regional data when determining benchmarks. CMS also proposed implementing deferment years, potentially affecting reimbursement timelines.
5. Government Healthcare Spending
The American Journal of Public Health recently released a study stating the United States government spends more on healthcare than any other country’s government. The co-authors analyzed expenditures from 2013, finding the government responsible for 64.3 percent of national healthcare spending.
Staying up-to-date with healthcare industry news is a helpful practice to keeping your clinic running smoothly. All of us at Healthcare Information Services, L.L.C. remain committed to educating our readers and keeping information accessible whenever you need it. Revisit our blog and subscribe to our newsletter for easy access to industry updates.