Starting in January 2015, Medicare payments will be determined by the 2015 Medicare Physician Fee Schedule. The rule brings a number of changes that are critical for doctors and practice managers to understand.

Join us as we review the key highlights of the CMS ruling, including:

Today, 13% of all US health systems offer health plans in one or more markets --commercial, Medicare Advantage (MA), or managed Medicaid. Together, these 107 systems operate health plans covering about 18 million members, about 8% of all insured lives. And there are more coming, with ten more provider-led plans being offered on the public exchanges in 2015.

25percentIf the government gives you money, you can expect that it will look to audit your results. Since 2011, CMS has disbursed nearly $20 Billion under the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs, to nearly half a million eligible professionals. It should come as no surprise that CMS now intends to audit at least 5% of Meaningful Use attesters.

What are your top practice priorities for 2015? According to research from MedData Group, physicians identified the successful implementation of ICD-10 as their top practice management initiative. At MDeverywhere we agree. The transition to ICD-10 will be catastrophic for the unprepared. As the code set increases dramatically, practices that are not fully prepared will likely experience an increase in denials, ballooning AR and reduced cash flow.

valuemodifierThe Value-Based Modifier Program (VBMP or VBM) was created to establish differential payment to physicians based on the quality of care provided to Medicare beneficiaries. Costs are measured during a specific time period and based on provider participation in the Physician Quality Reporting System (PQRS) program.

PQRS2015PQRS (the Physician Quality Reporting System) started in 2009 as Medicare’s quality incentive program. Since that time it has been steadily expanded and, going forward, there are only penalties.

VTSealWhen Vermont Governor Peter Shumlin announced last month the state was scrapping plans to create a single-payer system, he effectively pulled the plug on the only active effort by a state to implement a single-payer healthcare system. His announcement stated simply that the economics didn't work - meaning that the costs were too high.

PQRS2015CMS has released the Physician Quality Reporting System (PQRS) specifications for the 2015 reporting period and as expected, they are full of changes.

Doctor with PatientThere is no question that a physician practice's survival - let alone growth and expansion - in today's environment, requires navigating some pretty complex waters and a willingness to adapt quickly.

CPTIt’s that time of the year again when significant changes are introduced in the Current Procedural Terminology (CPT).

More than 500 CPT® changes are being implemented in 2015: