Revenue Cycle Management Issues Top AMA’s 2014 List
The American Medical Association’s list of top healthcare issues of 2014 features several Revenue Cycle Management topics.
- Last week, the American Medical Association released its list of the top ten issues that have impacted physicians in 2014. Unsurprisingly, a number of items on their list involved revenue cycle technology and challenges.
Progress toward payment reform
There were several strides made in the early part of the year to bring physician payment reform to the forefront. With a strong grassroots effort and a surprisingly open Congress, legislative policy was created to repeal the sustainable growth rate formula and considerably improve current law.
The biggest example of this happened in March when, after passing its 17 Medicare payment patch in just over a decade, both chambers and parties in Congress agreed to create new legislation that would alleviate this problem once and for all. While no movement has been made on reform of the sustainable growth rate (SGR), the talk from Congress is heading in the right direction.
“While we are disappointed that the fight for SGR repeal must continue, we are in a far better place to advance reform than we were a year ago,” AMA Immediate-Past President Ardis Dee Hoven, MD said earlier this year. “Rest assured that the AMA will continue to press for the changes we need to ensure our practices are sustainable and our patients have reliable access to the care they need.”
“Tsunami” of regulatory penalties
The regulatory penalty tsunami is a phrase coined by the AMA back in October. It refers to a number of potential payment cuts from the Centers for Medicare and Medicaid Services (CMS) over the next decade that could see payments cut by more than 13 percent. This has already started as HAC and meaningful use penalties have been handed out, each of which brings a reduction in Medicare payments of 1 percent.
“Physicians want to provide our patients with the best care possible, but today there are confusing, misaligned and burdensome regulatory programs that take away critical time physicians could be spending to provide high quality care for their patients,” AMA President Robert M. Wah, MD, said in a news release. “Government leaders should take the necessary steps to eliminate this regulatory nightmare and ensure America’s seniors can continue to receive the high-quality care they deserve.”
Sunshine Act and transparency
The Sunshine Act is one of the most noticeable ways that transparency has taken hold in the new year. Since the open payments database was launched in September, it has been tweaked several times and but is still not the useful tool it should be. However, each update and addition of information gets closer to that goal.
However, this is not the only way that transparency was a focal point. Back in April, CMS released Medicare claim data to the public. The information was raw, lacked context and could be misinterpreted. It had many of the same problems that would later hurt the Sunshine Act open database.
Hospital staffing
Mergers and acquisitions continue to be a major force in the healthcare market. Because of the growing financial challenges of running a hospitals, combining forces to create a multi-hospital, unified system is becoming a more popular tactic. However, CMS released a final rule in May that covers the need for a system-wide medical staff, instead of separate staffs at each hospital, and requires significant changes for physicians to meet guidelines. The rule does not take effect until May 12, 2015.
