Spending on telehealth services in the United States is expected to increase nearly tenfold in just five years.
According to projections from IHS Technology, telehealth spending per year in the United States will rise from just $240 million in 2014 to $2.2 billion in 2018. It is predicted that there will be 7 million telehealth encounters of all types by 2018.
The road to accountable care and value-based payment is a long one, chock full of obstacles along the way. But there are key checkpoints on the journey.
URAC’s Clinical Integration Accreditation standards address how to best position your organization to achieve success in a value-based economy, including governance, alignment, care coordination, and integrated infrastructure. Here are the top four things you need to know for clinical integration success:
We all know healthcare is changing, and the driver for much of this change is the government. MACRA (Medicare Access and CHIP Reauthorization Act of 2015), the latest sweeping healthcare reform law from Congress, is being massaged by CMS, and while most believe it is the physician at the tip of the MACRA spear, it will have a profound impact on pharmacists, too.
MACRA will fundamentally change how providers are paid. It’s about time. Fee-for-service, the “do more, get more” reward system that has sent us into an economic tailspin in healthcare may finally become a thing of the past. Under value-based payment, the foundation of the reward system will be quality. This change in philosophy, from volume to value, and the change in economics, requires a shift in the existing relationships among stakeholders.
There is sweeping new federal regulation that will impact the future role of managed care nurses and physicians in the most challenging of ways. This new law is referred to as “MACRA.”
MACRA will overwhelmingly affect pre-authorizations, clinical coding review, claim reimbursements, policy development, performance measures and coordination of care, defining new roles for Medicare providers and managed care professionals in the United States.
URAC launches the first independent, third-party telehealth accreditation program.
Telehealth is a powerful tool that can help improve health outcomes and lower healthcare costs. By creating efficiencies and extending the reach of existing providers, it has the ability to ameliorate healthcare workforce issues and can reduce health disparities for aging and underserved populations by overcoming access barriers and reducing both costs and burdens for patients around the globe.
Commenting on the imminent release of a final rule on the Medicare Access and CHIP Reauthorization Act (MACRA), Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andy Slavitt anticipated this new healthcare policy will give providers a “proliferation of opportunities.”
The final MACRA rule is expected to be released by CMS on or about November 1. It will implement the Quality Payment Program (QPP) that will replace the Sustainable Growth Rate governing Medicare reimbursements for providers treating Medicare beneficiaries. The QPP promotes value-based, coordinated care over the traditional fee-for-service method. It requires that participating practices cite progress through measures of performance.
With nearly two-thirds of Americans under the age of 65 covered by private insurance, no innovation in health care delivery can succeed without the support of health plans and employers. That’s why it’s not enough for the Centers for Medicare & Medicaid Services (CMS) to get behind the value-based reimbursement model; private payers need to get on board as well.
“To effect change in health care, you can’t do anything without employers and commercial insurers,” said Aaron Turner-Phifer, URAC’s director of government relations. “To have an actual long-term, coherent, seamless health care strategy, you need commercial insurers, private insurers and private employers working hand-in-hand with the things government is trying to do.”
While most healthcare providers agree the move toward fee-for-value is a positive advance for the healthcare industry, this shift away from fee-for-service isn’t coming without its challenges.
That’s especially true for providers who serve patients in rural and underserved areas and now must implement changes dictated by the Medicare Access & CHIP Reauthorization Act of 2015, or MACRA.
