OPPS 2017 Changes and Opportunities
Recently published proposed changes to the outpatient prospective payment system affect drugs and biologicals. Here are suggestions for how to implement
best practices.
New Part B Drug Payment Models
New proposals, models and rules from the Centers for Medicare and Medicaid Services, the U.S. Food and Drug Administration and the Department of Health and Human Services will affect payments this spring.
Narrative Medicine: How Stories of Illness Affect Caregiving
A physician diagnoses the condition and either treats it or refers the patient to someone else for treatment. End of story. Or is that just the beginning of the story? Narrative medicine challenges the medical model by bringing a new tool to the table: the story of the patient.
The Nurse Practitioner Will See You Now
Licensed to do many of the same procedures as physicians — often at a lowered cost — nurse practitioners are increasingly poised to change the face of primary care.
How Crowdsourcing Is Changing Medicine
How is crowdsourcing informing the doctor-patient relationship, and how can healthcare providers be prepared for the ways in which crowdsourcing is changing the dynamics in medicine?
The Shift to Payment for Value Continues: OPPS 2016 Final Rule
The Centers for Medicare and Medicaid Services issued the final 2016 hospital outpatient prospective payment system and ambulatory payment classification system policy changes and payment rates rule with comment period [CMS-1613-FC] on Oct. 30, 2015.
Drawing on the Past and Looking to the Future: The Role of House Calls in the Age of Modern Medicine
As technology advances and more options for healthcare delivery become available, a plethora of service models are emerging. One surprising model, the house call, seems to buck the high-tech trend.
ICD-10, Audits and Authorizations
The interrelationship between three major issues —ICD-10 conversion, the increasing burden of recovery auditor contractor audits and the need to streamline authorizations and meet local coverage determination and national coverage determination requirements— presents an interesting opportunity.
Biosimilars Debut in the U.S.
In light of the angst and hand-wringing over the soaring costs of biologic drugs that are alleged to be contributing to the unsustainability of biologic treatments, the U.S. Food and Drug Administration (FDA) approval of the first biosimilar in the U.S. was welcome news to many.
Payments for Healthcare: A New Day Is Coming
In late January, the Department of Health and Human Services (HHS) announced that it would fundamentally reform how it pays providers for treatingMedicare patients in the coming years. Speeding up the transition from fee-for-service to pay-for-performance and forcing Medicare to commit to this payment