<\/p>\n
I follow the Moskva,<\/i><\/b><\/p>\n
Down to Gorky Park,<\/i><\/b><\/b><\/p>\n
Listening to the wind of change\u2026<\/i><\/b><\/b><\/p>\n
\u00a0<\/b>So sang the gods of sound Scorpions, <\/i>about the fall of the Berlin Wall and other significant politico-economic changes that swept the world in the early 1990s. \u00a0The healthcare industry in the United States is currently in the midst of such an upheaval.\u00a0 Unfortunately, however, many in the healthcare industry (chiefly the providers)<\/i> may not be as optimistic about their futures, as Klaus Meine<\/i> obviously <\/i>was when he composed the legendary song.\u00a0 Let us look at some of these changes below.<\/p>\n \u00a0<\/b>Medicare payments have been nearly static for a decade, while costs for caring patients has increased by more than 20% in the same time period.\u00a0 The rationale for such a status quo is of course the escalating costs of healthcare and the burden it imposes on the wobbly economy.\u00a0 Medicare\/Medicaid spending, as a percentage of the GDP, has more than doubled since 1990s from around 2.5% to around 5%.\u00a0 This is expected to rise to ludicrous levels by 2050 to 13%, which of course could cause the economy to implode.<\/strong><\/p>\n \u00a0Thus the federal government\/CMS has initiated the following, which it hopes will curb overspending as against the Sustainable Growth Rate or SGR.<\/p>\n a.\u00a0 Quality Measure Reporting.<\/p>\n b. \u00a0Incentivizing the process of attainment of meaningful use.<\/p>\n c.\u00a0 Patient-Centric Medical Care.<\/p>\n d.\u00a0 Accountable Care Organization.<\/p>\n e.\u00a0 Exploring payment models other than fee-for-service.<\/p>\n \u00a0It has been strongly felt that payment under this model is not proportional to value, and rather than focusing on patient welfare and quality of healthcare it rewards only those who rake the highest volume.\u00a0 Thus, there is no demand and consequently no market for the most efficient outcomes and cost-conscious healthcare. \u00a0\u00a0Such a state of affairs, it is believed, will only further increase the costs of healthcare, and we will always end up paying more for less.<\/p>\n Although the fee-for-service is still the dominant billing payment model, it is expected to be replaced majorly (although not entirely) by other quality-centric models.\u00a0 And quality here means, not just raising the quality of clinical outcomes by a few notches, but in fact infusing quality consciousness across the board.\u00a0\u00a0 Thus it encompasses everything from counseling patients to referral management to medical billing and medical coding, <\/i>to HIPAA-compliant EHR usage etc.\u00a0 And ideally, each of these segments needs to be manned by experts in that particular line of work. \u00a0Expecting your front-office desk to do all of these perfectly day-in and day-out is just wishful thinking.<\/p>\n \u00a0\u00a0Thus, your clinic can prepare for these winds of changes in a top-down fashion; going through your providers first, down the food chain to the front-office personnel at the very bottom, who schedule appointments.\u00a0 Along the way it may not be a bad idea to outsource a process or two (like your medical billing <\/i>or medical coding<\/i>) to a medical billing specialist<\/i>.\u00a0 This would aid you in keeping down costs, while trying to prepare your clinic for the battles ahead.\u00a0 So perhaps, some day, providers may also emulate the Scorpions <\/i>and optimistically sing:<\/p>\n The future is in the air,<\/i><\/b><\/p>\n I can feel it everywhere,<\/i><\/b><\/p>\n I am blowing with the wind of change\u2026.<\/i><\/b><\/p>\n","protected":false},"excerpt":{"rendered":" I follow the Moskva, Down to Gorky Park, Listening to the wind of change\u2026 \u00a0So sang the gods of sound Scorpions, about the fall of the Berlin Wall and other significant politico-economic changes that swept the world in the early 1990s. \u00a0The healthcare industry in the United States is currently in the midst of […]<\/p>\n","protected":false},"author":2,"featured_media":928,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[743],"tags":[],"class_list":["post-927","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-practice-management"],"modified_by":"Erika Regulsky","_links":{"self":[{"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/posts\/927","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/comments?post=927"}],"version-history":[{"count":1,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/posts\/927\/revisions"}],"predecessor-version":[{"id":442334,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/posts\/927\/revisions\/442334"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/media\/928"}],"wp:attachment":[{"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/media?parent=927"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/categories?post=927"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/tags?post=927"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}PAYMENT REFORMS:<\/b><\/span><\/h2>\n
WHY FEE-FOR-SERVICE IS NOT FAVORED ANYMORE:<\/b><\/span><\/h2>\n
What This Means For Your Clinic:<\/b><\/span>\u00a0<\/b><\/h2>\n
USING OUTSOURCED VENDORS:<\/b><\/span><\/h2>\n