Medicare Advantage Plan – Increase In Pay By 0.4%
US Healthcare Providers and Facilities are facing a tough time due to the continual introduction of healthcare reforms like the Affordable Care Act (ACA) and Health Insurance exchanges. In addition, they are also subject to several payment cuts, which are widely affecting the normal medical billing and collections process and cash flow. The already-effective HHS sequestration cut and the now delayed SGR (Sustainable Growth Rate) payment cut of 24% (fixed till 1st April, 2015) are a few examples of such payment cuts. However, the CMS has recently announced a 0.4% increase to Medicare Advantage payments next year. Although this payment increase is quite relieving, several analysts keep debating if it really helps. Let us check out the reason for this debate:
Payment Cuts – An Overview: Over the past few years, the US healthcare domain has witnessed several changes including ominous reimbursement cuts. It has not only affected Providers’ medical
billing and collections, but also physician practice management companies.
· On April 1st, 2013, a 2% deduction on all services rendered by Healthcare Facilities and Providers was implemented.
· An additional 1.5% reimbursement cut will be implemented on medical billing and collections services, if Providers do not report PQRS (Physician Quality Reporting System) in the proper format by 2015. It is also expected to increase to 2% in the forthcoming years.
· The impending SGR payment cut of 24% is adding to their woes even though Congress took several measures like the Bipartisan Budget Act of 2014 to repeal the bill and provide a 0.5% payment rate increase for the next 5 years. The fix is only temporary and nobody has an insight into what will finally get decided by 1st April, 2015.
Payment Increase – Bane or Boon: While CMS had earlier proposed a 1.9% cut in February, it has announced on April 7th, 2014 that 2015 Medicare Advantage payment rates will be increased by 0.4%. It has alleviated a great deal of pressure handled by Providers. However, this payment increase cannot satisfactorily compensate for the aforementioned payment cuts. It seems like a small reduction in the overall reimbursement cut rather than a payment increase.
Impact: The financial challenges faced by Providers cannot be ruled out completely by this payment increase. However, it is helpful to a certain extent. Apart from facing financial loss, Providers are having a tough time carrying out the medical billing and collections processes properly. Physician practice management companies will be of great help in such scenarios. Providers must however choose the right one to outsource their medical billing functions. MGSI is one of the reputed and reliable physician billing solutions provider that renders exceptional services while Providers get adapted to the recurring healthcare changes and payment cuts.
With more than 20 years of experience in providing uncompromised physician billing solutions, MGSI has been a reputed physician practice management company in the US. This Florida-based national medical billing company will take care of all medical billing and collections processes while Providers concentrate on their core functions. To learn more details, log on to www.mgsionline.com.
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