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  • Spine code changes you can't afford to miss

    Much like the spine itself, medical coding constitutes the backbone of your revenue cycle. As more spinal procedures are performed on an outpatient basis in ambulatory surgery centers, minimizing surgical coding compliance errors is critical to sustainable revenue capture.
  • ASC, hospital outpatient pay rates should be the same, MedPAC says

    The Medicare Payment Advisory Commission proposed aligning Medicare pay rates for ASCs, hospital outpatient departments and physician offices during policy meetings April 7 and 8.
  • ASC case mix by region: 2022

    Gastroenterology comprises 41 percent of cases for ASCs in the Atlantic, the highest of any region, while orthopedics represents 20 percent of cases for surgery centers in the Mountain area, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022.
  • ASC payer mix as a percentage of collections: 2022

    ASCs in the South receive the highest percentage of their collections from commercial payers, followed by surgery centers in the Midwest, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022.
  • Why insurers, health systems are breaking up

    Insurers and health systems across the U.S. have been at odds during the most recent cycle of contract negotiations, and terminated contracts are affecting thousands of patients.
  • Aetna in the headlines: 5 updates in 30 days

    Aetna, a CVS Health company, insurers about 39 million people. 
  • Top payers by incurred claims 

    Kaiser Permanente Health Plans was the largest payer by total incurred claims in 2020, according to data firm Definitive Healthcare. 
  • Maryland physician to pay $500K billing fraud settlement: 3 details

    College Park, Md.-based internal medicine physician Anuja Kurichh, MD, has agreed to pay more than $500,000 to resolve billing fraud allegations, according to the U.S. Justice Department.
  • Centene in the headlines: 5 updates in 30 days

    Centene is one of the nation's largest health insurers by membership. 
  • National health spending has slowed since 2020, CMS report says

    Despite an increased demand for patient care in 2021, national health spending growth has slowed to 4.6 percent compared to 9.7 percent in 2020, according to a CMS news release shared with Becker's.
  • Florida physician gets 2 years in prison for fraud

    Miami physician Mark Zager, MD, was sentenced to two years in prison for healthcare and wire fraud, the Justice Department said March 24.
  • Insurer fined $339K after medical group, ASC contract termination

    Health Care Service Corp., the parent company of BCBS of Illinois, was fined hundreds of thousands of dollars after terminating its contract with a 600-physician medical group and ASC.
  • No winners, just losers and survivors amid payer issues

    Healthcare is not a one-size-fits-all industry. The current and projected U.S. healthcare and other industries labor markets are experiencing labor shortages that are driving up wages for qualified workers.
  • Anthem in the headlines: 7 updates from the last 30 days

    Anthem is one of the largest health insurance companies in the country by revenue and membership. 
  • The payer trends impeding ASCs today

    ASC owners and administrators are finding it more difficult to obtain payment from insurers as companies change coverage policies. But the current strain could push insurers and ASCs to find common ground on caring for the entire episode of care more efficiently and cost-effectively.
  • $15B in cumulative savings for physician practices is on the table, study says

    According to a study published in Health Affairs, if all physician practices performed at the level of "robust practices," they would save an estimated $14.9 billion on fee-for-service beneficiaries annually.
  • Fee for service becoming a 'steady march to the bottom'; What's next for ASCs?

    Physicians are clinging to fee-for-service payment to avoid the proverbial "race to the bottom" of bundled payments, which often cut pay rates.
  • Medicare payments to ASCs drop 6.4%: 12 MedPAC report stats 

    Medicare payments to ASCs dropped 6.4 percent between 2019 and 2020, according to the Medicare Payment Advisory Commission's March report to Congress. 
  • Physician pay freeze should stay, says MedPAC

    The Medicare Payment Advisory Commission recommended Medicare continue its physician fee payment freeze despite ongoing financial pressure from the pandemic.
  • MedPAC recommends CMS slash ASC conversion factor in 2023

    In its March report to Congress, the Medicare Payment Advisory Commission recommended cutting the 2023 Medicare conversion factor for ASCs and to require ASCs to report cost data. 

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