The Trend of Value-Based Healthcare in 2020

ONTARIO, Calif. - Jan. 23, 2020 - PRLog -- The reporting requirements and contractual differences between payers are getting complex. The payment models are not serving their purpose to the point, where they are beneficial.

To retaliate and speed up the progression and empowerment process of the healthcare system, CMS has announced to take constructive steps for better outcomes.

·         It (CMS) has aligned the E/M coding requirements for office and outpatient E/M visits as per the American Medical Association CPT Editorial Panel.

·         The four levels of E/M codes for new patients and five levels for established patients will continue at the same pace.

·         The Medicare Physician Fee Schedule conversion factor will see growth from $36.04 to $36.09 in 2020.

Moreover, if physicians don't choose to participate in MIPS 2020, they'll be facing a 9% reduction in their payments. Besides, the focus on quality reporting will be more than ever in 2020.

Medical practices that work on proactive care management and coordination of healthcare can earn more incentives and target bonuses. High performers also have a chance to join exclusive providers' organizations. But, it certainly requires efforts and investment.

Talking about the private payers, they have been investing more in the quality healthcare system. The health IT leaders are not seeing them reversing the process. In fact, the private paying industry is stretching its boundaries to accommodate homecare, pharmacy, and other sectors. The reimbursement potential can be increased when physicians tend to consider the general looking performance measures such as engagement rate, cost factor, patient access, and deliberately cheating those factors can even cancel the physician's license.

In 2020, big mergers between healthcare organizations will continue to grow and this will prove to be a challenge for healthcare organizations. Because logically speaking, large organizations and medical billing services are better able to offer well-established infrastructure. At the same time, the more physicians are getting along in big groups, the more it is difficult for them to work in harmony.

Smaller medical practices have a little disadvantage but they have dedicated physicians and certainly can use resources more efficiently.

Thus, every healthcare stakeholder is trying to work to harmonize the system and maximize reimbursements in one way or another.

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