Understanding the Fundamentals of MIPS and APM
MACRA has made three significant changes to the way physicians are being paid by CMS. The changes have created a quality payment program. With the recent changes in physician reimbursement model, physicians are allowed to choose one of the two paths in which payment is linked with quality.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) has suggested two types of payment models for health care providers. The focus is transition from the volume-based payment model to a value-based model. Eligible clinicians (ECs) will either participate in the MIPS or an APM model. These two are collectively known as the quality payment program for which the initial performance period starts from the year 2017.
The Two Paths of Payment
The two paths, namely, merit-based incentive payment system (MIPS) and advanced alternative models (APMs) are the new payment models. The general assumption of CMS happens to be that a large number of health care providers will be choosing MIPS during the current year.
APM Model
This is one of the new approaches of payment for medical care provided that incentivizes quality and value. APMs provide high-quality care in economical manner.
MIPS
This program combines the value modifier (VM), physician quality reporting system (PQRS), and the electronic health record (EHR) incentive program into one. Eligible professionals (EPs) will be measured using this metric.
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Warning Signs to Watch for While Using Care Credit Cards
It has become common among users to turn toward alternative financing when they need to pay for medical services that are not covered by their insurance. Care credit card is one of such options allowing individuals to meet their commitment in this regard.
The Fundamentals of Care Credit Card
Out-of-pocket payments for health care services have reached a staggering amount in the recent past and are growing about 5% every year, according to CMS. With the rise in this amount, the need for suitable ways to pay such bills is also growing.
Health care cards are being marketed by medical providers to individuals for covering medical expenses only. This can be used for covering select medical procedures that are not covered by insurance. Moreover, they are useful in covering portion of a medical bill not covered by insurance, such as deductibles.
More number of health care providers are finding it difficult to collect pending medical bills. Care credit cards are found to be a way to keep such bills from going into collections. Apart from the fact that care credit cards can only be used for covering expenses related to health care, they are also basically credit cards. This necessitates proper caution to be exercised in using the same.
What Consumers Need to Watch For
The following factors need consideration while trying to make use of care credit cards:
Retroactive interest rates
o With late payment, the introductory interest rate tends to skyrocket. In the case of some cards, higher interest rate may be retroactively applied. Card issuers may sometimes shorten payment cycles without notification to cardholders. Those missing a payment deadline end up paying their bills late inadvertently, thus triggering an unexpected jump in interest rate
Payment before getting services
o Upfront charging by certain health care providers is bound to happen at some point of time. In such cases, if patients end up not receiving or requiring some or all the services, or if the provider winds up business, patients will have to struggle for reversing the charges
Deciding during a vulnerable period
o Marketing care credit cards to people who are sick and require medical attention is not the right practice. Individuals amid a medical crisis rarely assess or compare alternative financing options
The following tips have to be borne in mind while using medical credit cards:
Get proper estimate on the cost of service and find how much your insurance policy will cover. See if any discounts are available in case you are required to bear the full amount.
Inquire and understand if direct payment to provider is possible over time. This way, you may avail better payment option than opening a line of credit
Upfront payment for multiple treatments must be avoided. Paying one at a time is better.
Go through the terms and conditions before signing up for care credit card.
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