Healthcare providers, using the directions mandated by federal and local governments, locked down their facilities to avoid the spread of COVID-19. This also meant shutting down main clinical service lines and canceling in-person appointments for patients. However, vendors are beginning to open their doors once again with the pandemic subsidizing in some regions.

According to recent data collected by The New York Times, the number of reported COVID-19 cases is dropping in close to half of states around the country, with several other states showing no statistically important change.

Just as healthcare facilities have decided to refrain from in-person appointments to minimize exposure, providers will also need to evaluate safety measures to reduce patient and provider contact with the coronavirus.

According to CMS guidelines, the optimization of telehealth services should be a major priority for healthcare facilities. Providers should remain focused on providing virtual care where appropriate to reduce the risk of spread of the virus, especially if they are dealing with patients that have severe or chronic conditions.

Should a scenario arise where in-person care is required, healthcare facilities should seek tele-triage services prior to resuming in-person care. Boosting remote patient monitoring and other telehealth capabilities may also assist providers with ensuring care access for patients who need medical care but are staying away from healthcare facilities due to understandable concerns.

To read more, please visit https://revcycleintelligence.com/news/key-considerations-for-reopening-healthcare-facilities-amid-covid-19.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Many providers and patients have not only become accustomed to the rapidly devised telehealth exemptions, but they also believe it’s an optimum approach to delivering basic healthcare services until the coronavirus is no longer a major threat. This positive attitude about telehealth may also serve as a way to ensure those changes, which some advocates of telehealth were big fans of long before COVID-19 surfaced, become the norm.

Earlier in 2020, CMS took considerable steps to relax regulations relating to the use of telehealth services, stating it was the proper response to make sure patients would still receive services while cities across the country were on lockdown to reduce the spread of COVID-19.

Just over two months later, access to remote care providers has exploded. The powerful American College of Physicists (ACP) lobbying group is one of the groups requesting the changes to remain in place on a long term basis.

In addition to easing regulations and compensation for telehealth services, ACP also wants the newly-granted autonomy to remain in effect in the direct supervision of doctors working at teaching hospitals, along with continuing fee increases for hospital divisions offering these services.

To read more, visit https://www.healthcaredive.com/news/calls-mount-for-cms-to-extend-telehealth-waivers/579264/.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

CMS’ latest and revised COVID-19 billing policy seeks to help hospitals and alternative care sites get paid for treatment given during the emergency. Late last month, CMS revised FAQs regarding Medicare fee-for-service billing. The revised FAQs provided more clarity on how CMS enforced an increase in hospital IPPS reimbursement, including the process involved in identifying COVID-19 discharges.

Most of the new questions focused on payments based on the Coronavirus Help, Relief and Economic Protection Act (CARES) for the Hospital Inpatient Prospective Payment Program (IPPS). The CARES Act, passed at the end of March, provides billions of dollars in funding to hospitals and other healthcare facilities, including a provisional 20% rise in IPPS patient reimbursements for hospitalizations related to the pandemic.

According to the FAQs, the amounts hospitals will receive for COVID-19 hospitalizations will vary based on the date of discharge. CMS issued the new payment rates for COVID-19 discharges on and after the 27^th of January and on or before the 31^st of March, as well as on or after the first of April, over the length of the emergency period.

Along with COVID-19 billing updates for the IPPS, CMS also provided guidelines on how hospitals should bill for services provided at alternative care sites developed to expand capacity during the emergency.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Telemedicine has been experiencing immense growth as a result of the COVID-19 pandemic. Practices as well as patients have more information available to them than ever as telemedicine moves to the forefront of healthcare. The next CareOptimize Insights webinar is all about helping you making sense of this new frontier.

This upcoming webinar exclusively discusses telemedicine, including relevant topics such as how it can assist your practice, the challenges it presents, the relaxation of regulatory matters, and where it is headed.

In regard to COVID-19, remember CareOptimize currently provides a pair of free tools to assist with simplifying the monitoring and reporting of coronavirus cases. The template allows you to log in data on patients who test positive or are exhibiting symptoms, then streamline notifications on those patients to the CDC, state health agency, and/or local health department. The report shows all high-risk patients in your organization who should be considered for additional screening or other preventative measures. Bookmark our Insights page or our YouTube channel to view all of our webinars.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, Nextgen EHR utilities, and more. For more information, please call 855.937.8475.

A relief bill aimed at COVID-19 relief would grant providers an additional $100 billion in aid for expenses related to healthcare and lost revenue caused by the coronavirus pandemic.

The Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, passed by the House on the 15th, is a $3 trillion coronavirus relief bill that seeks to supply further direct payments to an extensive array of coronavirus-affected agencies, businesses and even people. Healthcare organizations and agencies would receive a substantial part of the funding. The legislation also makes improvements to accelerated and variable payment plans under the Medicare terms and an improvement in prospective inpatient prospective payment system outlier compensation under patients that have received a COVID-19 diagnosis. The federal matching rate for Medicaid states is now rising by 14 percent and $75 billion has been set aside to support coronavirus testing and contact tracing.

Ever since the execution of a pair of coronavirus relief packages, the Coronavirus Aid, Relief and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act, hospitals have been petitioning for more federal government funding. Collectively, the packages provided a Provider Relief Fund of $175 billion.

To read more about the HEROES Act, visit https://revcycleintelligence.com/news/latest-coronavirus-relief-bill-seeks-another-100b-for-providers.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, Nextgen EHR utilities, and more. For more information, please call 855.937.8475.

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) proposed a new rule updating the Inpatient Prospective Payment System (IPPS). Beginning in October, CMS is proposing an update of three percent hospital market basket less a productivity adjustment of 0.4 percentage point. The new Medicare inpatient reimbursement rates will also represent a planned change of 0.5 percentage point mandated by legislation.

Along with these changes, the rule would also allocate nearly $7.8 billion in uncompensated care compensation, down $0.5 billion during the 2021 fiscal year. Furthermore, a new technology add-on payment mechanism will be developed for certain antimicrobial products.

Collectively, the CMS changes being proposed in unpaid care payments, new technology add-on payments and capital payments will reduce inpatient Medicare reimbursement rates by 0.4 percent, resulting in a total rise of approximately 1.6 percent in overall rates under the IPPS. These changes, which would affect more than 3,000 acute care hospitals and close to 300+ long-term care hospitals, would impact discharges occurring on or after October 1, 2020, according to CMS.

If you’re interested, the entire CMS rule proposal can be viewed at the following link: https://www.federalregister.gov/documents/2020/05/29/2020-10122/medicare-programs-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the. For more information about the rule, please visit the source article: https://revcycleintelligence.com/news/cms-proposes-to-increase-inpatient-medicare-reimbursement-by-1.6.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.

We recently uploaded episode six of the COVID-19 Insights Webinar. Topics featured in this webinar include the second round of CMS regulatory changes (including COVID-19 testing and home health changes), Medicaid provider grants, the rapid and continued expansion of telehealth programs, elective surgeries, and more.

We also spotlighted a few of the CareOptimize solutions launched in response to the pandemic, such as our FREE CareOptimize COVID-19 Template designed to allow logging of patient data for those who test positive or show symptoms. Our Crystal Report is also free and is useful for showing all patients within your organization deemed to be high-risk and who may need additional screening.

Episode six and the previous five episodes of our webinar series can be viewed on our YouTube channel: https://www.youtube.com/careoptimize. You’ll also find them on the Insights page of our website along with useful news regarding CMS updates and more: https://careoptimize.com/insights/.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.

CareOptimize continues to closely monitor the pandemic and its far-reaching implications on our industry. The challenges continue, and we want to keep you apprised of important trends in the COVID19 response, along with measures we have taken to help.

The COVID-19 Insights Webinar returns this week, where we’ll be covering widespread changes by CMS, how states continue to open for elective surgeries, existing loans and grants, and current telehealth opportunities. This week’s episode will be available on our YouTube channel at https://www.youtube.com/careoptimize as well as the Insights page of our website: https://careoptimize.com/insights/.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and have helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.

As a way to improve the healthcare system’s COVID-19 response, Centers for Medicare & Medicaid (CMS) has revealed more Medicare payment flexibilities to deliver telehealth, value-based care, and care beyond the traditional hospital during the pandemic.

Hospitals will earn secure, consistent Medicare payments by upping the number of beds for COVID-19 patients. This latest rule guarantees that facilities such as teaching hospitals, outpatient recovery centers, and community health service healthcare programs will not have to deal with decreased Medicare subsidies to raise the number of beds or patient admissions to minimize the pressure on the acute care system.

In turn, more companies will have the ability to supply and charge telehealth facilities, according to the rule. To broaden telehealth during the pandemic, CMS is forgoing limits on the kinds of providers that will deliver telehealth and is permitting hospitals to charge for remote care provided to hospital outpatients.

Long-awaited improvements to the Medicare Joint Savings Plan (MSSP) were among the flexibilities also announced. Furthermore, CMS revealed that the financial framework will be changed in assessing spending for accountable care organizations (ACOs). ACOs who accept increased financial risk under system rules in their next agreement cycle will also have the option of keeping the current financial risk standard for another year.

To read more, visit https://revcycleintelligence.com/news/cms-reveals-more-flexibility-with-medicare-payment-mssp-changes.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, Nextgen EHR utilities, and more. For more information, please call 855.937.8475.

Centers for Medicare & Medicaid (CMS) recently announced it will be suspending the Advance Payment System for doctors, practitioners that are not physicians, and other qualified suppliers of Medicare Part B. The federal agency is taking another look at the reimbursement rates charged by its Accelerated Payment Plan, a related advance payment system that funds Medicare fee-for-service providers when the filing and/or processing of claims is interrupted.

The CMS decision follows closely in the footsteps of President Donald Trump’s signing of the Paycheck Protection Program and Health Care Enhancement Act, which provides healthcare facilities more than $70 billion to cover revenue losses and other healthcare-related costs as a result of the pandemic.

The Accelerated and Advance Payment Programs have given nearly $60 billion in payments to more than 20,000 Part A providers since the COVID-19 pandemic began, hospitals included. CMS accepted close to 24,000 applications for Part B vendors, including doctors, non-physician clinicians, and medical supply providers.

Payments received by the services are not grants, however. According to revised program regulations in response to the health crisis, providers and suppliers are required to pay back the accelerated and advance payments within one year or less, based on the type of supplier or provider.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.