Ever since the Covid-19 pandemic pushed telehealth to the forefront of American healthcare modalities, the genie has emerged from the lamp to quite a mixed crowd of cheerleaders and cheaters.
CMS finalized updates to its physician fee schedule for 2024, as well as finalized the rule for next year’s Outpatient Prospective Payment System (OPPS). Provider groups are displeased with the updated rules, arguing that both physicians and provider organizations need more monetary relief than what the agency is offering.
As technology advances, AI-powered tools will increasingly reduce the administrative burdens on healthcare providers.
As value-based care models take hold, the time is ripe for rehab therapists to position themselves as primary players in the movement toward delivering optimal quality and value in the broader healthcare ecosystem.
CMS has shown that they understand the value and efficacy of remote care as a billable service for rehab therapists—let’s not miss this opportunity to take the best care of our patients while getting paid.
CMS recently established a unique code for AppliedVR’s flagship product, marking the first time a digital therapeutic or immersive therapeutic has ever been placed in an existing benefit category. The eight-week program is a physician-prescribed solution that allows patients to manage their chronic lower back pain without opioids from the comfort of their own home.
Just a quarter of healthcare practices offer remote patient monitoring, and the majority of them aren’t too eager to adopt the technology any time soon, according to a new report. A few factors are influencing this reluctance, including data security concerns, unclear reimbursement policies and training requirements.
The progress in artificial intelligence (AI) is reshaping patient care, across various dimensions, from facilitating faster discharge to curating treatment plans and suggesting lifestyle changes.
Ultimately, it is anticipated that CMS will further expand the use of reimbursable RTM beyond respiratory and MSK care and incorporate patient-reported information as a requirement for reimbursement of certain remote services.
Without reimbursement policies that can meet the opportunity of this new innovative era, patients and their providers will be denied access to the most cutting-edge, care.
The traditional fee-for-service arrangements have caused misaligned incentives across the board for patients, physicians, and payers – and proved a huge obstacle to improving care. Recognizing this gap, CMS began to facilitate a shift towards outcome-based care by focusing on outpatient monitoring and disease management. This has led to progress in adopting new reimbursement models.
In a phone interview, Matt Fisher, a partner with Mirick O'Connell, said CMS' latest actions regarding virtual care are beneficial but noted doctors shouldn't forget about the privacy and security side of the coin.
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.
In a sample of 100 claims from 2014 and 2015, 69 met telehealth service requirements and the other 31 did not, resulting in an estimated $3.7 million in extra costs.
This year, CMS promised reimbursement changes for telemedicine and remote patient monitoring in 2018. Meanwhile, the FDA unveiled its pre-certification pilot program for digital health. Despite being significant, these noteworthy events leave room for improvement in 2018.
“The ways it’s structured now, the large practices will do well and the small practices will do badly,” said Paul Ginsburg, director of the Center for Health Policy at the Brookings Institution.
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The penalties, created by the federal Affordable Care Act, have incited a vehement debate about quality at many academic medical centers often revered for cutting-edge treatments and top specialists. Are these vaunted hospitals really more dangerous than local, unsung hospitals?