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Breaking Down the CMS Medicaid Integrity Strategy

Posted Aug 28, 2018

What is the CMS Medicaid Integrity Strategy?

The Centers for Medicare & Medicaid Services (CMS) developed the Medicaid Integrity Strategy to combat abuse, fraud, and the waste of Medicaid dollars. The Medicaid Integrity Program was the first comprehensive Federal strategy aimed at combating the abuse of the Medicaid program. This program aims to keep Medicaid sustainable for years to come, especially with Medicaid spending increasing dramatically over the past decade.

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ACR Reassured by CDS Delay in MPFS Final Rule

Posted Jan 18, 2018

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The MPFS Final Rule

The MPFS final rule was announced in the last quarter of 2017 with a concluding decision regarding proposed operational changes in radiology. The U.S. Centers for Medicare and Medicaid Services (CMS) illustrated these comparative distinctions alongside a push back of clinical decision support (CDS) until January 2020. Luckily, the ACR and other medical facilities will experience no cuts to radiology procedures. IDTFs will also benefit from the reduced cuts originally proposed by the CMS. Overall, radiology received a budget neutrality adjustment with many other positive updates and revisions that have favored practices in an unexpected turn of events.

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Converting your Top Ortho ICD9 Codes to ICD10

There are many orthopedic coding that will come with the switch from ICD-9 to ICD-10.This free guide will help you understand ICD-10, prepare for it, and give you the resources to guide your transition.

CMS Field Testing to Evaluate MACRA Episode-Based Cost Measures     

Posted Nov 1, 2017

Field Testing of Episode-Based Cost Measures

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The Centers for Medicare & Medicaid Services (CMS) and its contractor, Acumen, LLC, is conducting a field test for eight episode-based cost measures from October 16 to November 15, 2017. This is before considering their potential use in the cost performance category of the Merit-based Incentive Payment System (MIPS) of the Quality Payment Program (QPP). During the field test, affected clinicians may access confidential feedback reports with information about their performance on these new measures, which CMS will use to contemplate measure refinements.

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5 Key Concepts for Payor Reform in Spine Surgery

Posted Aug 30, 2017

Payor Reform Opportunities for Spine Surgery

A recent article published in Clinical Spine Surgery observed payor reform opportunities for spine surgery. The article, written by Jason Scalise, MD, and David Jacofsky, MD, focuses on bundled payments, and the demands for spine surgery to implement bundled payment strategies. Spine procedures are projected to increase dramatically due to age demographics and other population factors. Substantial focus is being put on this division of musculoskeletal care to find a way to drive consistency and value. The trends and increasing pressures by government and commercial payors to drive accountability to the level of the surgeon should not be thought of as a passing phase by spine surgeons. Below are five key concepts for payor reform in spine surgery from the article.

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