On Demand Webinar | Intermediate | Payment, Reimbursement, and Managed Care
Payment uncertainty in the U.S. healthcare system has become an exhaustive burden for all stakeholders - and further amplified by COVID-19. Healthcare costs and inconsistent volumes demand a holistic, long-term strategy for financial viabil...
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Course | Intermediate | Payment, Reimbursement, and Managed Care
This course describes the regulatory agencies that have authority over healthcare organizations, including the Centers for Medicare and Medicaid Services. It also explains how Medicare and Medicaid function as payers, and how different kind...
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Course | Basic | Payment, Reimbursement, and Managed Care
This course explains how to complete FL 1-41 of the UB-04 billing form. This course covers the use of this form for all payers, including Medicare, Medicaid, and commercial payers. The course describes each form locator and provides detaile...
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Course | Basic | Payment, Reimbursement, and Managed Care
This course explains how to complete FL 42-81 of the UB-04 billing form. The codes needed to fill in these data areas are described. The course covers the use of this form for all payers, including Medicare, Medicaid, and commercial payers....
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Live Webinar | Payment, Reimbursement, and Managed Care
This Spring, Medicare is offering a final enrollment opportunity in the Bundled Payments for Care Improvement Advanced ("BPCI-A") model for new participants. Hundreds of hospitals and physician groups are actively participating in BPCI-A, a...
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Fact Sheet | Payment, Reimbursement, and Managed Care

Specialty Care Models to Improve Quality of Care and Reduce Expenditures Final Rule Summary

Fact Sheet | Payment, Reimbursement, and Managed Care

Specialty Care Models to Improve Quality of Care and Reduce Expenditures Final Rule Summary

On September 21, 2020, CMS placed on public display a final rule that will implement two CMS Innovation Center models focused on providing specialty care to Medicare fee-for-service beneficiaries with cancer and end-stage renal disease, respectively. The final rule is scheduled to be published in the September 29, 2020, issue of the Federal Register. The Radiation Oncology Model provides a bundled payment for an episode of radiation therapy to treat certain types of cancer. The End-Stage Renal Disease Treatment Choices Model makes payment adjustments intended to incent fully-informed beneficiary choices of renal replacement therapy options through adjustments to current payments to facilities and clinicians and by increasing flexibility in the delivery of the kidney disease education benefit. Participation in both models will be mandatory for eligible participants (facilities and clinicians) in selected geographic areas, and both models will begin in calendar year 2021.

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