The challenge is on for the private sector to take the new Medicare payment data, and everything else that's there, and create decision-making tools seniors can use. Then there's the long-term transparency challenge for government and the healthcare industry.
The meaningful use program progresses from its launch in 2011, and the federal government continues to pay out billions in incentives. Now, some members of a federal advisory board question the sluggish start so far for 2014.
The panel hasn't had a meeting and no one's even been nominated for it yet, but the Obama administration's fiscal 2015 budget request says the health law's Independent Payment Advisory Board, also known as IPAB, could save the government triple what officials estimated last year.
Congress has prepared a bill that would repeal Medicare's troubled physician payment system, paving the way for reform -- if only a way of funding the bill could be agreed upon. The American Medical Association is more optimistic about passage of this bill than it has been in the past ten years.
Medicare Advantage (MA) plans are private health plans that have contracted with Medicare to receive a fixed monthly fee in exchange for providing comprehensive healthcare to plan members. In order to provide appropriate care to beneficiaries with varying medical conditions, plans are paid according to the Risk Adjustment Factor (RAF) score of each patient. Insufficient documentation of chronic conditions can be an obstacle to MA reimbursement. However, even when a condition has been properly documented by the provider, it is often not coded and submitted to Medicare. Read this white paper to learn how to take the complexity out of MA reimbursement.
Once medical practices install ICD-10 compliant software and train all their staff members appropriately, they can't call it good. They need to work with their trading partners to keep business on track after Oct. 1.
Even if the administration and CGI Federal, the contractor doing much of the health insurance marketplace IT work, did actually share the code with developers could the open source community put it to work?