An interesting week in payment thinking

March 10, 2016

Last week’s health care headlines revealed some interesting trends regarding the ongoing shift toward alternative payment models.

Some examples:

— Takeaway: As of January, CMS estimates that roughly $117 billion out of a projected $380 billion in Medicare fee-for-service (FFS) payments are tied to an alternative model.

— Takeaway: A 2016 HIMSS cost accounting survey revealed few providers feel they are “highly prepared” to make the value transition.

— Takeaway: According to the article, 95 percent of all provider visits are paid via the FFS model, which is actually a 1 percent increase from 2013.

Bottom line: Medicare thinks they are receiving 30 percent of payments through alternative payment models even IF these are fee-for-service models. Most practices are actually getting FFS payments — 95 percent, in fact — and everyone feels they are not quite ready for the future.

Contact Mick Raich, president of Vachette Pathology and Stark Medical Auditing, at 517-486-4262 or at to learn how our consultants can work with you to make sure your practice is prepared for the ongoing shift toward APMs.


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