It is widely accepted that multidisciplinary rounds are essential for the success of a case management department, especially in ensuring achievement of their metrics. Case management metrics have a broader scope, more so than ever before; the number of metrics, ranging from financial to quality, is growing all the time.
21st Century Oncology, a national network of cancer providers headquartered in Fort Myers, Florida, came under scrutiny by the Department of Justice (DOJ) and the Office for Civil Rights (OCR) earlier this year. In December, the organization agreed to a $26 million settlement with the DOJ and a $2.3 million settlement with OCR. 21st Century Oncology filed for bankruptcy in May.
This week's note provides an overview of the eligibility, scope of coverage, effective dates, premiums, and cost-sharing amount policies under the four parts of Medicare. .
Most physicians are familiar with the MIPS quality models: These are the Physician Quality Reporting System (PQRS) measures that we’ve been reporting for years with the old Medicare value-based purchasing program. What we don’t know much about are the new cost efficiency models in MIPS, which are based solely on hospital and physician ICD-10-CM/CPT claims data rather than a clinical abstraction of our medical records.
