Most otolaryngologists likely have heard about reference pricing, the relatively nascent concept that a payer—be it a person, a plan, or a pension fund—contributes a set amount toward specific procedures. The most public example of the model is the California Public Employees’ Retirement System (CalPERS), which in 2011 began using the concept to determine what […]
Alternative Payment Model Promises More Penalty Than Pay
Under the MIPS, Medicare reimbursement for physicians will be a function of quality determined by the so-called Value-Based Payment Modifier (VBM) and the Physician Quality Reporting System (PQRS)
Hybrid Physician Payment System Can Ensure Quality, Customer Service
A reader highlights how hybrid compensation approach can incorporate clinical guidelines, decrease cost without compromising quality of care
Physician Pay Shifts from Volume to Value
Relative value unit payment system could replace complex, variable physician compensation model that exists today
Medicare Payment Data Release Concerns Some Otolaryngologists
Without way to refine data or validate its accuracy, physicians concerned misperceptions could impact doctor–patient relationships
Tips for Coding Inferior Turbinate Surgery
Ensure proper coding of procedures for inferior turbinate hypertrophy surgery to maximize reimbursement
Lower Reimbursement, Greater Regulation Threaten to Shutter Sleep Centers
Plan needed to reposition centers to be economically viable in new third-party payer and regulatory climates
Price Cut Generates Momentum Behind Push to Revamp SGR
Possibility of repealing and replacing Sustainable Growth Rate Medicare reimbursement formula seems more likely than ever, say congressional lawmakers
Medicare Physician Payment Cut Averted
A 27.4 percent Medicare cut was scheduled to begin Mar. 1.
Payment Shifts: Expect reimbursement structure changes ahead, policy experts say
Although the new U.S. health care law does not specifically alter the current fee-for-service payment structure, changes to how physicians and hospitals will be reimbursed for services are under construction. These changes are reflected by the growing focus on the development and implementation of quality improvement and physician and institutional performance measures on which reimbursement will increasingly be made, panelists said here on Sept. 11 at the 2011 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Annual Meeting.
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