AAPC’s Post

CMS has released the 2025 Medicare Physician Fee Schedule!   Here are a few of the key takeaways:   ➡ 2.8% cut in the conversion factor ➡ The addition of a new Advanced Primary Care Management program to enhance care access ➡ Extended telehealth flexibilities ➡ Enhancements to the Medicare Shared Savings Program   These changes aim to address disparities, foster value-based care, and support primary care providers. However, many provider groups are pushing for longer-term payment reform. For a deeper dive, check out Heather Landi’s article in Fierce Healthcare: https://lnkd.in/dnv9kugb We have added a link to the CMS fact sheet in the first Comment. #Medicare #HealthcarePolicy

🚨 2025 Medicare Physician Fee Schedule Update The recent Medicare Physician Fee Schedule proposal for 2025 could have a significant impact on healthcare providers and practices across the country. 🏥 Check out this insightful article with comments from MGMA to learn more about what these changes might mean for your practice and how to prepare. 💡 👉 https://lnkd.in/guC9-_h2

As we continue to unravel the intricacies of Medicare costs, let’s shift our focus to Part B for 2024. Often seen as the outpatient counterpart to Part A, it covers physician visits, physical and speech therapy, diagnostic tests, and more. With a $240 calendar year deductible, it is designed to cover 80% of approved expenses. The remaining 20% is the beneficiary’s responsibility, highlighting the importance of either budgeting for these out-of-pocket costs or considering supplemental insurance to bridge the gap. Moreover, while clinical lab services are mostly covered, blood transfusion services present a cost-sharing scenario after the first three pints. Home healthcare, when involving necessary medical equipment, is typically covered. These details are not mere figures, they represent a critical guide for beneficiaries to plan their healthcare finances with clarity and confidence. Remember, understanding these costs is not just about the numbers—it’s about securing your health and financial well-being for the future. Different people have different circumstances and one solution does not always fit all. You can find more information you in the Medicare app “What’s covered” from CMSgov available through the typical app handlers.

According to CMS, every Traditional Medicare beneficiary in the country should be in an accountable care relationship by 2030. The question for many providers is no longer whether to participate in value-based care, but which programs to consider and how to determine the best fit. Read our latest blog post to learn about the impact and evolution of the Medicare Shared Savings Program, ACO REACH, and other upcoming models shaping the future of value-based care. #medicare #valuebasedhealthcare #valuebasedcare #healthcareindustry #healthcareinnovation #acoreach #mssp

It is important to know the mix of Medicare patients versus private payer patients who will receive your technology. Many hospitals will note that they don't make much or maybe lose money on Medicare payment, but the payments they receive (on average) is signficantly more than Medicare.

With the CMS 2025 Medicare cuts now official, doctors are speaking out on what these changes mean for patient access and the healthcare system. Learn more with this Cardiovascular Business article ➡️ https://lnkd.in/gAxsdGwM

The aborting of healthcare. Corporations and government see health care as unnecessary expenses, unplanned medical leave, and a void when employees need a time to recover. Simply, survival of the fittest. Ballot proposals of ~250 characters become volumes of laws in directions no employee-constituent would intend. Often the Proposal Titles are misleading, nor constituent recourse provided if laws exceed the Proposal. The terms: unfortunate, untimely, unplanned, accident, all apply to all adults experiencing illness, disease, injury too. Aborting health care coverage to retirees that have worked, contributed taxes, defended, upheld, provided community, country, and corporate standards now experience the health care being aborted as are today's employees that pay high insurance, high co-pays, and reduced health care services. Not a complaint, just an observation.

Fascinating strategy by CMS: Final rule for 2025 includes a 2.9% cut to Medicare physician payments, even as practice costs continue to rise. Cuts like these threaten practice viability, especially in underserved areas, limiting access to care. We need sustainable Medicare reform that keeps pace with inflation. #Healthcare #Medicare #MedicareReform #PhysicianAdvocacy https://lnkd.in/gKKEuH3i

Value-based care rewards quality over quantity. As healthcare organizations warm up to the idea, CMS and commercial payers must choose which arrangements they will offer to their provider partners. This article provides an overview of the four main categories. https://ow.ly/9Ab350QuOH5

The release on July 10 of the proposed Calendar Year 2025 Medicare Physician Fee Schedule from the Centers for Medicare & Medicaid Services (CMS) is causing consternation among national healthcare associations, who are criticizing both the 2.93-percent decrease to physician reimbursement contained in the proposed schedule, and some elements around benchmarks in the Medicare Shared Savings Program (MSSP) that are contained in the proposed schedule. The announcement was posted late on Wednesday afternoon on the CMS website, in the form of a press release. The press release began thus: “Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), proposed new policies in the calendar year (CY) 2025 Medicare Physician Fee Schedule (PFS) proposed rule to advance health equity and support whole-person care. The proposed rule would also strengthen primary care, expand access to behavioral health, oral health, and caregiver training services, maintain telehealth flexibilities, and expand access to screening for colorectal cancer and vaccinations for hepatitis B. The proposed rule reflects the Biden-Harris Administration’s vision for affordable, high-quality care for all Americans while driving innovation in the Medicare program. https://lnkd.in/evHXrt5t