Download or read book Practice Expense Methodology and Data Collection Research and Analysis written by Lane F. Burgette and published by . This book was released on 2020 with total page 134 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this report, the authors address how the Centers for Medicare and Medicaid Services (CMS) can improve the methodology or update data used for setting practice expense (PE) rates for payments made under the Medicare Physician Fee Schedule (MPFS). The current system for setting PE payment rates relies, in part, on data collected in the Physician Practice Information (PPI) Survey, which generally reflects information from 2006. Because of changes in the U.S. economy and health care system since that time, there are concerns that continued reliance on measures that use PPI Survey data might result in misvalued PE rates. To the extent that future payment systems use MPFS rates as a starting point, misvalued PE rates might be problematic if they are not updated. The research in this report, which is part of the second phase of a study, can be divided into three broad topics. First, the authors consider how updated PE data could be collected through a new large-scale national survey effort to replace the PPI Survey. Second, the authors consider a new framework for allocating PE, which they developed to better capture variation in PE resources that are required to provide services covered in the MPFS. Finally, the authors continue work begun in Phase I of the project and documented in a previous report, Practice Expense Methodology and Data Collection Research and Analysis, investigating the potential to make use of data collected to set rates in the Outpatient Prospective Payment System (OPPS). Throughout the report, the authors focus primarily on indirect PE, which includes such expenses as administration, rent, and other forms of overhead that cannot be attributed to any specific service.
Download or read book Practice Expense Data Collection and Methodology written by Lane F. Burgette and published by . This book was released on 2021 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Each year, Medicare allocates tens of billions of dollars for indirect practice expense (PE) across services on the basis of data from the Physician Practice Information (PPI) Survey, which reflects 2006 expenses. Because these data are not regularly updated, and because there have been significant changes in the U.S. economy and health care system since 2006, there are concerns that continued reliance on PPI Survey data might result in PE payments that do not accurately capture the resources that are typically required to provide services. In this final report of the second phase of a study on PE methodology, the authors address how the Centers for Medicare & Medicaid Services (CMS) might improve the methodology used in PE rate-setting, update data that inform PE rates, or both. The authors conclude that this information is best provided by a survey; therefore, they focus on the advantages and disadvantages of survey-based approaches. They also describe the use of a lean model survey instrument, as well as partnering with another agency to collect data. Finally, the authors describe a virtual town hall meeting held in June 2021 to give stakeholders an opportunity to provide feedback on PE data collection and rate-setting. The system of data and methods that CMS uses to support PE rate-setting is complex; thus, CMS must take into account a number of competing priorities when considering changes to the system. With this in mind, the authors offer a number of near- and longer-term recommendations.
Download or read book Practice Expense Methodology and Data Collection Research and Analysis written by Lane F. Burgette and published by . This book was released on 2018 with total page 154 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report addresses concerns that aspects of the practice expense (PE) valuation methodology used to determine the Medicare Physician Fee Schedule (MPFS) contribute to misvalued payment rates. The fee for each service is denominated in relative value units (RVUs). The report proposes potential improvements in the current methodology used to allocate indirect practice costs in determining PE RVUs for a service and assesses alternative data sources that could be used to regularly update indirect practice cost estimates. A number of potential policy changes are recommended for improving the rate setting of PE. The most sweeping change would be to adopt relative values for total PE based on the Outpatient Prospective Payment System (OPPS), which is used to value outpatient hospital visits. Potentially, OPPS-based costs could be used to inform or replace the MPFS PE valuations. This change would reduce site of service payment differentials, simplify Medicare payment policy, and improve returns from rate-setting resources since cost information would be shared between the two Medicare payment systems. There are a number of methodological issues that would need to be resolved before this change could be implemented, but the potential benefits are great enough to justify investments to further develop this option. Alternatively, new data could be collected to update PE valuations using the current framework. The report proposes survey processes that could minimize survey burden in order to facilitate on-going data collection. Improving payment accuracy would support improved payment policies in many other areas of the country’s health care system.
Download or read book Revising Physician Practice Expense Payments written by United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 1998 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Physician Payments written by U S Government Accountability Office (G and published by BiblioGov. This book was released on 2013-06 with total page 62 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) ongoing efforts to develop resource-based practice expense relative value units (RVUs), focusing on: (1) whether the new methodology is an acceptable approach for revising Medicare's fee schedule; (2) questions about the data, assumptions, and adjustments underlying the new methodology that need to be addressed during the 3-year phase-in period; and (3) the need for future updates to the practice expense RVUs to reflect changes in health care delivery and for ongoing assessments of the fee schedule's effect on Medicare beneficiaries' access to physicians' care.
Download or read book Medicare written by William J. Scanlon and published by DIANE Publishing. This book was released on 1999-10 with total page 58 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report evaluates the Health Care Financing Admin. (HCFA) proposed practice expense revisions & also includes information on HCFA's ongoing efforts to refine its data & methodologies. Specifically, it focuses on (1) HCFA's approach for estimating the practice expenses directly associated with each medical service or procedure; (2) 2 methodologies HCFA used to adjust the direct expense estimates; (3) practice expenses excluded or limited by HCFA; (4) HCFA's method for assigning indirect practice expenses to each medical service or procedure; & (5) the potential impact of the new fee schedule allowances on beneficiary access to care.
Download or read book Medicare written by William Scanlon and published by . This book was released on 1998 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Physician Payments written by Robert F. Dee and published by DIANE Publishing. This book was released on 2000-12 with total page 58 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 1992, Medicare began using a fee schedule to pay physicians for more than 7,000 procedures. A fee schedule amount for each procedure is computed by multiplying the sum of the procedure's three rankings, known as relative value units (RVU), by a conversion factor that translates RVUs into dollars. This report monitors the Health Care Financing Administration's. ongoing efforts to develop resource-based practice expense RVUs. It focuses on: evaluation of whether the new methodology is an acceptable approach for revising Medicare's fee schedule; questions raised about the data, assumptions, & adjustments underlying the new methodology that need to be addressed during the three-year phase-in.
Download or read book Medicare Physician Payments written by United States. General Accounting Office and published by . This book was released on 1999 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Data Collection and Analysis for Generating Procedure specific Practice Expense Estimates written by Abt Associates and published by . This book was released on 1997 with total page 496 pages. Available in PDF, EPUB and Kindle. Book excerpt: Multi-volume report details results of Abt Associates efforts to collect and analyze data for constructing resource-based practice expense relative values in support of the phasing-in of the Medicare Fee Schedule by the Health Care Financing Administration (HCFA).
Download or read book Summary of Technical Expert Panel on Updating Practice Expense Allocation in Medicare Physician Fee Schedule written by and published by . This book was released on 2020 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt: On January 10, 2020, the RAND Corporation convened a technical expert panel with leading professionals and experts on the topic of updating the allocation of practice expenses (PEs) in the Medicare Physician Fee Schedule. Panel members were encouraged to share their candid views on the current PE data, the process by which PE data are collected, the process by which data inputs are converted into payment rates, and how each of these components might be improved. This paper provides a summary of the themes that were addressed.
Download or read book Medicare physician fee schedule CMS needs a plan for updating practice expense component report to congressional committees written by and published by DIANE Publishing. This book was released on with total page 43 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Report on the Survey of Practice Costs written by United States. Health Care Financing Administration. Office of Research and published by . This book was released on 1997 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Physician Payment written by United States. General Accounting Office and published by . This book was released on 1993 with total page 20 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Physician Payments written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2018-02-10 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt: HEHS-99-30 Medicare Physician Payments: Need to Refine Practice Expense Values During Transition and Long Term
Download or read book Hehs 98 79 Medicare written by United States Accounting Office (GAO) and published by Createspace Independent Publishing Platform. This book was released on 2018-02-10 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt: HEHS-98-79 Medicare: HCFA Can Improve Methods for Revising Physician Practice Expense Payments
Download or read book Medicare physician fees geographic adjustment indices are valid in design but data and methods need refinement report to congressional committees written by and published by DIANE Publishing. This book was released on with total page 54 pages. Available in PDF, EPUB and Kindle. Book excerpt:
