Course | Basic | Medicare Payment and Reimbursement
In this course we will address scheduling processes, including<div><ul><li>Patient identification</li><li>Requested service</li><li>Medical necessity screening</li><li>Medicare Advance Beneficiary Notice of Noncoverage processing</li><li>Pa...
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Course | Overview | Medicare Payment and Reimbursement
This course provides a brief history and overview of Medicare and Medicaid. It describes government organizations that regulate and administer this program. This course also discusses Medicare reimbursement. In addition, it highlights recen...
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Course | Intermediate | Medicare Payment and Reimbursement
This course provides an overview of the prospective payment systems used in the Medicare program and as well as Medicare fee schedules. This course provides a general discussion and overview of Medicare reimbursement under the Inpatient Pro...
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Course | Intermediate | Medicare Payment and Reimbursement
This course provides a general discussion and overview of reimbursement provided by Medicare under the outpatient prospective payment system. It also discusses the use of ambulatory payment classifications in the outpatient prospective paym...
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On Demand Webinar | Intermediate | Medicare Payment and Reimbursement
As the senior population continues to outpace the relative growth of the general population, and Medicare Advantage is accounting for about one-third (and growing every year) of all new Medicare eligible enrollees, providers are increasingl...
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How To | Medicare Payment and Reimbursement

5 actions leaders can implement for success

How To | Medicare Payment and Reimbursement

5 actions leaders can implement for success

To be successful with value-based contracts, healthcare leaders should take the following actions:

  1. Work from transformed practice models that use advanced care practitioners and care teams, with everyone at top of license.
  2. Reinvigorate the health system’s Annual Wellness Visit program and receive the triple benefit of engaging beneficiaries, receiving beneficiary assignment and capturing diagnoses and risk coding.
  3. Schedule an HCC self-performance audit and conduct a staff refresher course, assess the organization’s chart review program and understand how it is measuring HCC accuracy and its risk score. 
  4. Reduce total cost of care by using a population health platform to identify the health system’s top opportunities and prepare a strategy to address those costs on day one.
  5. Develop and implement three to five impactful initiatives to deploy for 2020, communicate about the initiatives broadly and stay the course for success. 

About the Author

Sheila H. Fusé

is senior vice president, policy and payment models, Navvis
(Sheila.fuse@navvishealthcare.com).

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