Payors adopting EPP are mainly prioritizing connectivity that meets their needs – gaining access to necessary clinical documentation and quality outcomes to adjust risk scores of beneficiaries (and associated government reimbursement) as well as enhance their rankings against other health plans.
Read MoreMonth: August 2023
The Real Cost of Medicare Advantage Plan Success
Medicare reimbursement rates have never covered the total cost of care, so when MA reimbursement falls below that already-low baseline, hospitals are left to absorb the difference. With rising costs, record inflation and dwindling labor, many hospitals simply can’t afford to cover the difference anymore.
Read MoreNew ID Requirement for HOPDs Passes House Committee
The stated goal of this bill is to prevent HOPD rates from being paid for services rendered in free-standing physician offices or other settings that should be reimbursed at a lower cost. There is also speculation the bill might be the first step in a larger reimbursement model overhaul aimed at aligning HOPD reimbursement rates with those of ASCs and physician practices.
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