On February 6, a bipartisan, bicameral proposal was announced to replace the current Sustainable Growth Rate (SGR) formula and create new physician payment mechanisms. I volume grows while per capita GDP slows, as has been the case over the past decade, then the formula calls for rate cuts – at a time when the total cost of providing patient care is increasing.
Continuing uncertainty about future changes to regulation, reimbursement, and costs for orthopedic services is creating an environment of change for physician-owned ambulatory surgery centers (ASCs). As a result, owners of independent orthopedic ASCs are increasingly looking toward alignment and integration strategies in response to major market trends and as a means of offering greater value to patients.
Increased demand for higher quality, lower costs, and more coordinated care is driving provider consolidation across the country, including the orthopedic ASC market. As a result, there are complex dynamics that must be evaluated in determining the future viability of independent, physician-owned orthopedic ASCs.
Over the past decade, orthopedic and musculoskeletal (MSK) services have been immune to many of the negative reimbursement trends experienced by other specialties. Now, however, that immunity is beginning to wear off.
As we head into 2014, hospitals and health systems are confronting a number of challenges to remain competitive in their respective markets. The emphasis on cutting costs and reducing reliance on hospital utilization will be felt across the entire healthcare industry, but there are unique obstacles – and solutions – facing each different type of organization.
The PPACA created state-specific health insurance exchanges, now referred to as “marketplaces,” that are designed to offer consumers a side-by-side comparison of available health plans. This article addresses the challenges of health exchanges and provides recommendations for providers regarding proactive operational and strategic tactics to achieve success in the new healthcare reform era.
This Massachusetts Medical Society (MMS) publication provides detailed guidance on the issues that physicians should consider if they are currently participating in an accountable care organization (ACO), forming or joining an ACO, or entering into an integration agreement with another healthcare organization.
This article is the second in a series that describes the most common types of hospital/physician payment arrangements within an academic medical center.
The recent frenzy of physician practice acquisitions has created a sense of urgency for hospitals and health systems to complete these transactions quickly in order to remain competitive. This article discusses six elements necessary for a professional fee billing operation to be successful.
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