CareHarmony’s Post

Value-based care, anyone? If shared quality and outcomes are the foundation of VBC networks, MSSPs, and ACOs, why are hospital-owned physicians and groups still compensated based on volume (relative value units)? This RVU-based compensation system can only last until legislation appears on the horizon. Quantity will never equal quality. #ValueBasedCare #HealthcareReform

From Larry Benz's Substack . . . in the latest draft of the 2025 CMS Physician Fee Schedule, the proposed rate reduction sent to all providers is 2.93%. Like most things from CMS coiffers, don’t believe the fine print. The reality for physical therapists is that significant cuts to NMS re-education (4.7%) and therapeutic exercise (5.4%) will weigh their overall cut much greater because there is generally a higher use of these more advanced clinical competencies. This proposed cut demonstrates CMS is trying to eliminate PT’s as both a profession and a service as it will make seeing medicare patients an ethical balance of wanting to treat patients that need us most but at rates that are likely less than cost. By the way, in Medicare logic the explanation for the reduction in those two codes is simply their growing and increased use. Yes, reimbursement (along with research) drives practice-in this case not something CMS receives well. What should be applauded for the use of these advanced competency codes is thus punished and the skills of PT further marginalized. Expect to see medicare patients given the worst appointment times, extended wait lists, and handouts for recommendations to other centers willing to take patients at below cost. By 2025, the total impact on physical therapists, considering both the cumulative conversion factor cuts and inflation, will be approximately 13.93% (10.33% cumulative conversion factor cut + 3.6% inflation increase). This significant reduction in real terms is compounded by the unprecedented inflation rates we’ve seen over the past few years: 7% in 2021, 6.5% in 2022, 3.4% in 2023, and roughly 3% year-to-date in 2024. . . . and that does not factor in the PTA differential . . .but hey they might get rid of the POC requirements and let PTAs see Medicare patients in OP environments . . .for less money Happy Wednesday

Get a sneak peek at the future of primary care with our latest blog on the 2024 Physician Fee Schedule. Delve into how fee-for-service changes, updates to attribution, and strategic benchmarking improvements support the ACO model: https://ow.ly/BNsk50Q8tsB #PhysicianFeeSchedule

The 2024 “Medscape Physicians and RVUs Report” from March 1 – May 26 reported that more than half of physicians find the RVUs unfair and not accurate and current. Some physicians cited increased pressure to increase patient counts and to use higher billing codes. #CostFlex #hospitaldecisionsupport #costaccounting #healthcareleadership We can help you look at not only your costs and service lines but compare different physicians as well. https://lnkd.in/gzpS79ab https://lnkd.in/gDv_6fDm

Are they unfair? Let us help you analyze that data. CostFlex can allocate physician practices and professional services costs (Direct Variable, Direct Fixed, and Indirect) by RVUs to show profitability and contribution margin by Physician Group, Specialty, or Physician by Physician. #decisionsupport, #healthcare, #healthcareleadership, #hospitals, #hospitalmanagement, #costaccounting, #ruralhealthcare, #ruralhospitals, #ruralhealth, #costflex, #revenuecycle, #contractmanagement

When seeking care with a Kaiser Permanente Physician, members can rest assured that 'Prior Authorization' for necessary services is not a concern. At KP, our physicians rely on decades of evidence-based medical practices and utilize the World's most sophisticated EMR, eliminating the need for prior auth and pre-cert requests. This approach not only enhances the patient experience but also reduces waste in the care continuum and the system, ultimately leading to improved health outcomes. #Healthcare #PatientExperience #KaiserPermanente #EvidenceBasedMedicine

Get a sneak peek at the future of primary care with our latest blog on the 2024 Physician Fee Schedule. Delve into how fee-for-service changes, updates to attribution, and strategic benchmarking improvements support the ACO model: https://bit.ly/3G3XXWd #PrimaryCare #PhysicianFeeSchedule

Did you know that the 2024 Medicare Physician Fee Schedule reduced the conversion factor (i.e., reimbursement) by 3.4%? https://buff.ly/3siRkMp Changes in reimbursement have a direct and disproportionate impact on physician practice profitability, which can translate into a material adjustment in practice valuation and/or physician compensation. #Healthcare #Valuation #Physician #MPFS

RPM, remote patient monitoring, is becoming ever more present in the healthcare industry. It is able to provide an additional level of patient care, thus yielding improved clinical results. On top of that, Medicare has rolled out CPT® Codes for RPM, allowing for practices who provide it to receive Medicare reimbursements. Having reliable devices to make the reimbursements achievable is one part of the equation, and having consistent readings is another. The result of this equation is.... https://bit.ly/41c09o5 #RemotePatientMonitoring #RPM #ChronicCareManagement #CCM #MedekRPM #Healthcare #Medicine #HealthTech #HealthcareTechnology #MedicalDecisions #PatientFirst #HealthcareBlog #DigitalHealthcare #Insights #TechInMedicine

"As of January 2024, Definitive Healthcare reports that there are over 338,000 physician group practices in the United States. In an independent physician practice, shareholder physicians typically take home all earnings of their business and have discretionary expenses..." Read the full article, "How Post-Transaction Physician Compensation Structure Affects Fair Market Value of Physician Practices" here: https://lnkd.in/gX5qFCxT Written by Dylan Alexander and Gerrit Elzinga #physicianpractice #healthcareindustry #physiciancompensation #medicalpractice #healthcarevaluation #physicianownership #practicevaluation #healthcarefinance #VMGHealth #VMG