How Could President Biden’s Healthcare Plan Affect Your Practice?

By implementing the American Rescue Plan, the Biden administration is delivering its promise to bring down healthcare costs.

Believing that the people deserve the peace of mind that comes from knowing they can take care of their health without going into debt is the inspiration behind the strengthening of the Affordable Care Act. The plan lowers costs for those buying plans on the exchanges. But what will these sweeping reforms to the healthcare system mean for you and your facility?

As with any changes in the healthcare system, you will need to develop strategies for successfully adapting through shifting reimbursements. This includes focusing on your medical billing process to ensure the highest possible returns on your services. With extensive experience in various niches including hospitals of all sizes, we can help you find opportunities that can allow you to achieve optimum reimbursement. We will show you how to employ the best practices to ensure you reduce debt and unpaid bills while maximizing your profits. 

Key Components of the Biden Plan

The Biden administration is aiming to patch gaps in coverage for Americans. In many ways, the Biden plan echoes the Obama administration’s more aggressive approach to healthcare. Their bold ideas for new healthcare policies will most likely have a tremendous impact on both patient and provider. 

Addition of a Public Option 

Biden’s plan proposes giving Americans a new choice for health insurance: a public insurance option similar to Medicare for customers on the individual market. This means working-age adults—not just the elderly—are allowed to buy into a public insurance plan as opposed to a private plan. Since Medicare rates are lower than private insurance, the public options would be cheaper than most insurance alternatives. While this would expand the number of covered individuals, it would also mean lower reimbursements for providers.

Extending Subsidies For More Americans

All healthcare organizations should be prepared for the possibility that millions of Americans will now obtain insurance. The Biden administration is pushing to increase subsidies by lowering the income share that subsidized households pay to be covered. The possible change in eligibility for the subsidies may also ensure more Americans qualify for income-based tax credits that lower premium costs.

Expansion of Medicare to Americans Age 60 and Over

Biden also wants to lower Medicare eligibility age from 65 to 60. This would greatly expand the beneficiary population, to roughly 20 million more Americans for both Medicare and Medicaid. This could result in a dramatically low reimbursement rate for facilities, as Medicare rates for admitted patients are on average half of what commercial insurance plans pay. The loss of commercial payments for adults 60-64 would eliminate an important revenue stream for providers and add new financial pressure to already struggling facilities.

Changes on the Horizon

Though the Biden administration has yet to release the many specifics of their healthcare reforms, you should prepare for significant changes. Your facility may benefit from an overall organization analysis to determine how lower reimbursements would impact your revenue stream while keeping abreast of relevant changes in the industry. Rest assured that we are monitoring the progress of the bill closely and will be able to alert you to changes as soon as they occur.

As with any changes in the healthcare system, you will need to develop strategies for successfully adapting through shifting reimbursements. This includes focusing on your medical billing process to ensure the highest possible returns on your services. With extensive experience in various niches including hospitals of all sizes, we can help you find opportunities that can allow you to achieve optimum reimbursement. We will show you how to employ the best practices to ensure you reduce debt and unpaid bills while maximizing your profits.

Lower Reimbursements Require Higher Efficiency

Coronis Health can help you stay on top of issues that matter most. While remaining constantly vigilant and compliant amid the ever-changing landscape of the healthcare industry, we can help ensure your facility remains current in medical billing and coding regulations. By bringing together the best healthcare revenue cycle management and medical billing professionals, we have the workforce and technology to provide the most current and innovative solutions to optimize the billing process, minimize errors, lower your costs, and comply with the latest regulations.

We understand that we are all at a crucial time where every penny counts. If more insured Americans means lower reimbursements, there should be no room for any errors that would further cripple your financial success. We know that your facility’s stability and growth heavily depend on an  efficient revenue cycle. Therefore, now is the time to make your billing process more efficient than ever. 

How Coronis Can Help You Increase the Efficiency of Your Billing for Higher Revenue Overall

With over 100 years of combined experience providing billing and coding services to facilities, practices, and hospitals, our team of experienced and certified billers and coders understand the importance of getting the process right. To successfully balance quality patient care with the cost of providing it, we have developed a proven, end-to-end, revenue cycle solution based on the measured value we deliver to healthcare providers. This model includes a distinctive operating partnership and an aligned financial relationship, coupled with leading-edge resource and technology positioning.

We have succeeded in working with our valuable partners to not only maintain their collections but also increase the collection amount and efficiency in which our clients receive payment. Our transparency, actionable intelligence, ability to conduct financial analysis and reporting, and wide-ranging experience in inpatient and outpatient networks, give us the ability to provide excellent medical billing services tailored to your specific needs, allowing you to maintain financial independence and focus on what you do best.

Ensure Future Success with Coronis Health

Coronis Health is ready to assist you in evaluating your facility’s processes and workflows. If you have concerns about your practice’s revenue cycle or future, contact Coronis to learn more about our consulting services or to request your free financial checkup.

from
https://www.coronishealth.com/blog/how-could-president-bidens-healthcare-plan-affect-your-practice/

What Value-Based Care Could Mean for Your Facility

A healthcare facility’s revenue is tied to its patient reimbursement model. Any shift you make in the reimbursement process can have a significant impact on your financial health.

Providers are now looking into a new healthcare reimbursement model that can streamline healthcare and cut costs called value-based care. This model is based on the quality of care rather than quantity. In other words, your facility gets rewarded for providing quality care to patients, which means better patient care while lowering costs and improving cash flow.

With over 100+ years of combined experience, Coronis Health is well versed in sliding scale and other payment models. We design our medical billing and revenue cycle services specifically for facilities to optimize their revenue cycle and increase cash flow. We identify and capture missed revenue or find new revenue streams. Our goal is to implement the appropriate systems into your workflow so you can enjoy a healthy bottom line.

Value-Based Care vs. Fee-for-Service

Under the traditional fee-for-service model, healthcare providers invoice for each service or procedure they perform. Instead of bundling, the patient pays for services separately. This system incentivizes providers to complete as many services as possible to bring in more revenue.

Under the value-based care model, healthcare providers receive compensation based upon patient health outcomes, encouraging them to deliver quality care. In a value-based reimbursement model, effectively managing an individual’s and population’s health generates revenue. 

Many organizations have already embraced a value-based care system as one of the most efficient methods for lowering healthcare costs while increasing quality care and ultimately helping communities lead healthier lives.

Benefits of Value-Based Care

This new care delivery and payment system provides such benefits for facilities and patients alike as:

• Patients spend less money without compromising health: Since value-based care is focused on quality, patients don’t have to pay for services they don’t need. Furthermore, the model focuses on establishing solutions agreed upon between patient and provider, resulting in patients recovering from illnesses more quickly or avoiding them in the first place. This means fewer tests, procedures, and doctor’s visits, resulting in spending less money while improving health.
• Greater efficiency and patient satisfaction: To improve the quality of care, providers focus on developing medical solutions and prevention-based services and fostering better relationships with patients. All these strategic changes can contribute to increased patient satisfaction. 
• Lower costs and reduced risk: Value-based care lowers costs. Insurers have to pay less money for services that their clients use, making insurers less likely to raise deductibles and premiums. Furthermore, value-based payments encourage efficiency by allowing payers to use a bundled payment system that covers all a patient’s care.
• Prices will match value: Supply and demand determine physician services and prescription pricing. A value-care model may contribute to price changes that reflect the value that services and medications give patients. By focusing on the patient rather than the number of services provided, it becomes easier for manufacturers to align their products’ prices to the value they offer.
• Healthier society: Value-based care aims to help make your community healthier. By focusing efforts on providing efficient treatments and preventing illnesses, patients and insurers spend less money on disease management, emergencies, and hospitalizations. This means fewer chronic conditions as well. The healthier society is as a whole, the less money all parties have to spend on healthcare.

Value-Based Care Models Your Facility Can Use 

Since different payment structures enable facilities to measure value in various ways, providers may use other methods to implement them based on their or the payers’ needs. Examples of models include:

• Accountable Care Organizations (ACOs): In this care delivery model, hospitals, doctors, and other healthcare providers work together to deliver quality care to patients. This model relies on the networked team’s cooperation. When healthcare providers collaborate, stay accountable to providing high-quality care, and agree on the patients’ treatment plans, they avoid redundancy and excess services. 
• Bundled payments: Healthcare providers collectively receive payment for the costs of treating a specific condition, which may cover several procedures and physicians. But the bundled payments system is more than just grouping together a list of services. By paying for value rather than volume of care, bundled payments provide a better level of care by establishing a structure that appoints providers as clinical leaders while keeping risk manageable.
• Patient-centered medical homes: This care delivery model focuses on centralizing patient care through a primary care physician. Like ACOs, this model requires providers to work as a team to create holistic care settings conducive to catering to patient needs. Using electronic medical records (EMRs) is one great way to collaborate. EMRs provide easy access to patient information, allowing providers to retrieve procedure results quickly. By sharing information, providers get to avoid redundancy and its associated costs.

How Value-Based Care Can Create Success for Your Facility

Transitioning from volume to value takes on a more proactive and preventative approach to patient care. Employing a value-based care system will likely encourage you to build on data, technology, and collaborative efforts. In effect, you’ll develop a more integrated approach for managing people’s wellness instead of treating illness as it occurs.

The new models incentivize healthcare providers to engage patients, use data analytics, and upgrade health technologies and software, which all aid in improving the quality of care. Because when patients receive appropriate, effective, and coordinated care, they also reap the benefits. By improving your revenue cycle management strategies, you get to reduce cost-to-collect, increase cash flow, and ensure maximized collections with fewer denials.

Shift to Value-Based Care with Coronis’ Help

Value-based care is a relatively new concept for most healthcare providers. You will need to refocus your revenue cycle management system to include population health management, more efficient billing and coding techniques, and more data analytics tools. Outsourcing may be your best solution to improving your current system with value-based care in mind. To learn more, contact Coronis Health to request your free financial check-up.

from
https://www.coronishealth.com/blog/what-value-based-care-could-mean-for-your-facility/

The Top 5 Pandemic-Related Challenges Facing Primary Care Practices

Even before the pandemic, many primary care providers were struggling with unsustainable practice costs and burnout. COVID-19’s disruption of the healthcare delivery system, however, poses additional challenges to primary care.

According to a recent survey, facilities must adapt to shifting workflows, implementing new billing and coding practices, and building platforms for telehealth services—all while dealing with lower practice revenues. Coronis Health stays abreast of what is shaping health care. We understand the pandemic’s economic repercussions and are aware of the changes necessary to maintain primary care financing. We are a national healthcare revenue cycle management and medical billing company offering global capabilities and tailored solutions. 

 We know the pandemic pressures may be overwhelming. Still, we can help your facility strengthen its resilience by implementing the appropriate tools and strategies for staying afloat while you deliver the best patient care possible. By understanding the following challenges you are facing, you can equip your facility with the best practices for thriving amid the COVID-19 pandemic.

1. Medical Billing Code and Rules Changes

According to a survey conducted by the Primary Care Collaborative and the Larry A. Green Center, over half (52%) of surveyed clinicians report that their practice is often overwhelmed with constantly changing information, including medical billing codes. 

Healthcare providers should have a seamless accounting system, especially now that you face significant pressures to diagnose, treat, and provide follow-up care. Precise medical billing creates the potential for a positive cash flow, and to accomplish this you must use up-to-date medical codes and follow new regulations.

2. Patient Questions 

The spread of misinformation is a dangerous part of the pandemic. The seamless communication inherent in social media has been so efficient at spreading misinformation about COVID-19 and vaccines. 

Over 60% of surveyed clinicians report spending “a significant amount of time” correcting misinformation about the pandemic with their patients. They say there has been an alarming increase in patient distrust of public leaders (58%) and patient doubt of primary care and their practice (15%). The volume of COVID-related questions can be overwhelming. While physicians feel that the correction of misinformation is a core part of their mission, fielding questions means more effort to develop rapport with patients, which takes time away from administrative responsibilities.

3. Expanded Telehealth 

Telehealth services have become an integral part of primary care as it has grown more prevalent among patients due to its safety and convenience. While transitioning to telemedicine has effectively kept patients healthy during the pandemic, the shift has created revenue challenges for facilities trying to stay financially stable during this difficult time. In addition to lower reimbursement rates, about a quarter of clinicians who participated in the survey reports their practice’s fee-for-service volume is still more than 30% lower than pre-pandemic levels. 

4. Less Revenue 

Most primary care facilities reported dramatically reduced revenue in the early stages of the global health crisis. Generally, these facilities did not have large financial reserves to sustain them during the pandemic. Monthly expenses are also running higher than usual (e.g., higher cost of PPE). Furthermore, the financial impact caused by the decrease in in-person visits has led to some independent practices to close (2%) or merge with larger organizations (5%).

5. Loss of Staff 

The financial woes of primary care facilities have led to cutting costs, reducing their salaries, imposing staff furloughs, and implementing pay cuts. A quarter of the survey respondents (25%) have permanently lost staff, and nearly 63% reported colleagues out to COVID-19 exposure, diagnosis, or quarantine.

How Coronis Can Help

Primary care physicians are enduring daunting challenges during the pandemic, but a combination of innovative external support and business intelligence may help them to keep serving patients.

We are a global innovator in the fields of medical billing services and revenue cycle management. We’ve brought together the best of the best in medical billing. We are also invested in staying up-to-date with the latest laws and regulations, awarding you peace of mind that your facility’s medical billing practices comply with new laws, regulations, and industry standards, including codes related to COVID-19 and its vaccines. Combined with industry-leading innovations and high-touch experience, we will allow you to focus on your patients, whether by combating misinformation or delivering high-quality care—all while maintaining your independence and financial security.

We always keep a pulse on industry changes, including the expansion of telehealth services. With 100 years of combined experience, we are here to help organizations adapt to the paradigm shift in healthcare policies and new technologies. Throughout the pandemic, Coronis Health has quickly become the designated expert for COVID testing billing. We’re trusted to handle tens of thousands of claims because of our experience and innovative mindset.

Coronis is invested in your financial success. Not only do we save you money by outsourcing all billing and coding, but we help you find lost revenue, close aged payments, and lower your time in AR. Coronis Health focuses on getting you the “last dollar.” We are at the forefront of using Artificial Intelligence and the latest software to revolutionize how we collect. These innovations lead to increased and groundbreaking efficiency and savings and prevent you from compromising your staff or the quality of your patient care.

Partner with Coronis Health

It is essential to form strategies to better cope with the disruptions and financial fallout caused by the COVID-19 pandemic. Coronis Health has all the resources necessary to handle your facility’s billing obligations and financial requirements, providing you with the freedom to focus exclusively on patient care. To learn more about our tailored solutions and forward-thinking strategies or to request your free financial checkup, contact Coronis Health today.

from
https://www.coronishealth.com/blog/the-top-5-pandemic-related-challenges-facing-primary-care-practices/