Recent rulings from the CMS offer an opportunity to reevaluate specialty mixes, surgical offerings and professional practice offerings against existing managed care contracts to ensure revenue cycle health. 

Here are five key things to know about value-based care going into 2023:

Chicago-based Benjamin Toh, MD, has been charged for his role in a more than $9.5 million healthcare fraud scheme, the Justice Department said Dec. 14. 

Springfield (Ill.) Clinic, a multispecialty physician practice with an ASC, launched a health plan, according to a Dec. 8 report from the Illinois Times.

Here are four leaders' thoughts on reimbursements:

Here are four Cigna updates reported on by Becker's since Oct. 21:

Here are six updates from UnitedHealthcare, one of the largest payers, since Nov. 17:

Here's how much physicians were paid on average over the last five years, pulled from Medscape's physician compensation reports:  

Two leaders joined Becker's to discuss whether payers are pushing procedures to ASCs and other outpatient settings. 

Payers are increasingly issuing policies that push patients outside of hospital settings, according to Laren Tan, MD, chair of Loma Linda (Calif.) University Health's department of medicine. 

Here are three fast facts on prior authorization:

The Mississippi State Board of Medical Licensure and the Board of Pharmacy have issued a joint statement on its compliance rules for ASCs dispensing controlled substances, JDSupra reported Nov. 9. 

ASCs have historically faced obstacles to reimbursements, and ASCs in some markets are seeing increased pressure from payers. 

The Colorado Purchasing Alliance created an initiative that allows employers in the state to negotiate lower prices for healthcare services through a cash incentive, the Kaiser Family Foundation reported Nov. 2.

Three ASC leaders joined Becker's to discuss the financial losses providers are seeing in 2022:

Here are three breakdowns of ASC operating costs to know:

 CMS updated ASC payment rates to 3.8 percent in its 2023 "Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule." 

The Surgery Center of Fort Collins (Colo.) is working on collecting past due bills more than two months after it announced it was closing for good, BizWest reported Oct. 26.

Payers UnitedHealth, Elevance (formerly known as Anthem) and Centene are some of the largest insurers by membership. 

Becker's has reported on three physician or physician assistant fraud cases since Oct. 6.