Providers Push For New Payment Systems

Health care providers increasingly are embracing payment systems -- based on ideas such as bundled payments, accountable care organizations and medical homes -- that reimburse based on treatment as a whole rather than the fee-for-service model.

USA Today: Health Care Providers Want Faster Changes In Payments
Health care providers are pushing the federal government to scrap the payment plan for medical services, preferring instead one payment for a patient's entire care instead of separate fees for each item. Instead of fee-for-service medicine, in which a provider receives a payment for every test, procedure and visit, providers want the government — or states or private payers — to pay for treatment as a whole. In theory, physicians would provide treatments that have been proven to work but are also cost-effective (Kennedy, 4/14).

Meanwhile, Medpage Today reports on developments regarding accountable care organizations -

Medpage Today: More Docs Joining Forces In ACOs
The number of physician-led accountable care organizations (ACOs) has recently surpassed the number led by hospitals, becoming the largest backers of the payment and delivery model, an analysis showed. Last March, hospital-led ACOs outnumbered those headed by doctors nearly two to one (91 to 45), said Neil Kirschner, PhD, ACP senior associate of regulatory and insurer affairs. But after the Centers for Medicare and Medicaid Services (CMS) approved a new batch of ACOs earlier this year, physician-led organizations outpaced their hospital counterparts (202 to 189), he reported at the American College of Physicians (ACP) annual meeting (Pittman, 4/14).

In addition, Medpage Today also reports on the challenges of coding for the ICD-10 system -

Medpage Today: Docs' Charting Falls Short Of ICD-10 Demands
Nearly 65 percent of clinical documentation doesn't contain enough information for coders to use for billing under the upcoming ICD-10 coding system, a coding expert said here at the American College of Physicians annual meeting. The switch to the new coding system will greatly increase the specificity of diagnostic codes, and most doctors don't provide enough detail for office coders to translate that to ICD-10, said Rhonda Buckholtz, vice-president of ICD-10 education and training at AAPC, a medical coding society based in Salt Lake City, Utah. Her estimate of the percentage of charts that were inadequately documented came from a survey of patient charts done by the AAPC, but further detail on the survey was not provided (Pittman, 4/12).

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