Far too often, healthcare organizations treat planning and execution as two separate processes which are intended to achieve a larger goal. Leadership makes plans and departments and workers are told […]

For several years now we’ve had four -X modifiers, generally presented as -X (E, P, S, U) which can be used instead of the -59 modifier to unbundle procedure codes […]

Hierarchical Condition Categories (HCCs) have been the underlying risk adjustment for many Medicare programs for several years. But they didn’t attract wide interest until CMS began shifting more payment toward […]

Value-based payment models are attracting attention for risk adjustment methodologies, especially HCC risk adjustment, which is used to calculate cost benchmarks for Medicare Advantage and other CMS payment models including […]

A recent survey in Healthcare Informatics  on physician readiness for implementing MACRA indicates a strong need for assistance and support.  The overall results of readiness of physicians polled show that […]

I paraphrase, but this is essentially the question we hear from providers when we talk about ICD-10 coding accuracy.

Happy New Year and thank you to all our readers! Before we officially start 2017, catch up on five of Inside Angle’s most read blogs of 2016: Overcoming skepticism about […]

In a recent perspective piece in JAMA Forum, Dr. Ashish Jha of the Harvard School of Public Health argues that increased provider consolidation is threatening the financial viability of the […]

So, this month I am taking a slight detour. Instead of continuing to dissect AHRQ version 6.0 changes, I would like to reflect on providers and quality. I promise to […]

In early October, CMS surprised everyone and published the highly anticipated Final Rule on MACRA well ahead of schedule. A number of blogs have since provided high-level summaries of the […]

Congress passed MACRA in a bi-partisan (yes it actually can happen!) effort.  The Center for Medicare and Medicaid Services (CMS) released the 900-page proposed rule on April 27, 2016, requesting […]

Congress has declared a national objective to achieve widespread exchange of electronic health information nationwide by December 31, 2018. By this July, the U.S. Department of Health & Human Services […]