on April 12, 2013 |
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Topics: Utilization Review, Payer Relations, Reimbursement, Finance, Medicare, Payer and Regulatory Policy, Revenue Cycle, Imaging, Service Lines, Referral Management, Physician Issues, Utilization, Efficiency, Performance Improvement
Ben Lauing, Imaging Performance Partnership
President Obama’s proposed budget may signal major reforms in store for imaging. Self-referral, an issue often debated but rarely acted upon, is now an explicit target; the Obama administration has proposed restricting the in-office ancillary services exception to the Stark law. Furthermore, the budget suggests mandatory pre-authorization for advanced imaging modalities.
While this is only a proposed budget, and Congress could take it or leave it, we think it’s highly likely that regulations to curb imaging utilization will soon emerge.
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President Obama targets self-referrals and pre-authorization
on March 21, 2013 |
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Topics: Health Care Reform, Market Trends, Strategy, Payer and Regulatory Policy, Medicaid, Reimbursement, Finance, Pediatrics, Service Lines, Imaging
Ben Lauing, Imaging Performance Partnership
My colleague Robin Brand recently spoke at the Children’s Hospital Association’s Radiology Directors Forum in Houston, where she discussed several of the key forces currently impacting pediatric imaging programs. Much of the conversation focused on health care reform, and, in particular, the current state of Medicaid expansion.
While increased eligibility for Medicaid will have a disproportionate impact on children’s hospitals, as Medicaid covers a significant number of uninsured children, Medicaid expansion will impact all providers.
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Medicaid expansion’s impact on pediatric volumes, doughnut holes, and reimbursement
on January 4, 2013 |
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Topics: Imaging, Service Lines, CT, MRI, Reimbursement, Finance, Medicare
Shaun Lillard, Imaging Performance Partnership
The American Taxpayer Relief Act passed the House of Representatives late Tuesday night to avert the fiscal cliff, but Medicare did not go untouched. The last-minute “Doc-Fix”, preventing a 26.5% cut to the Sustainable Growth Rate (SGR) for physicians was again offset by cuts to other Medicare programs.
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Fiscal cliff deal prevents SGR cuts at expense of EUR—Implications for imaging
