ACE ALERT: Provider Reimbursement Models for The Future

 

Times are changing with payment for medical services. To improve patient care while lowering costs, payors are exploring alternative payment models (APM). A goal at CMS is cultivating an affordable and accessible healthcare system that puts patients first. One of the initiatives is bundled-pay. A bundled payment methodology involves combining the payments for physician, hospital, and other health care provider services into a single bundled payment amount. The participating entities will receive bundled payments for certain episodes of care as an alternative to fee-for-service payments, which was authorized through Section 3021 of the Affordable Care Act. The intent of a single bundled payment to health care providers is to motivate health care providers to furnish services efficiently, to better coordinate care, and to improve the quality of care. The result can realize a gain or loss.

How alternate payment models can be adapted to your practice.

ACE has been in the billing, coding, and managed care evaluation business for a very long time.  One of the new things that should be addressed in contracts is to negotiate out of EFT fees that are now being charged for transactions.  Our auditors have expertise in organizing your information and compiling data to help you understand where you are and what you need to get to your true goals.  If you would like help with any of the steps above, give us a call.