It looks like exchange enrollment might meet the CBO's expectations after all. But exchanges and insurers will have a lot of post-operative challenges, not to mention the fight to survive in some states.
Doctors can no longer be considered by themselves or by their patients as the ones knowing everything about the patient's care. A cultural revolution needs to change everyone's thinking: it's a team effort.
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.
More and more importance is being placed on how a hospital communicates with a patient. Be it through a portal or mobile-optimized website, that connection ties into patient satisfaction rates and, eventually, the bottom line.