MACRA : “A” is for Access and “C” is for Children
MACRA's vision is that early interventions with children are key to reduce costly chronic diseases later in life. For this to work, education, access and health data interoperability are imperative.

MACRA : “A” is for Access and “C” is for Children

MACRA Changes Health Care Economics with a Focus on ChildrenMACRA Background: A final rule released on Oct. 14, 2016 by the Centers for Medicare and Medicaid Services (CMS) details the final…

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Will Healthcare Go the Way of Farming in the U.S.?

a focus on income support has remained constant. We can assume that based on recent U.S. policy certain incentives and regulations will continue in healthcare and that the general effect will be to encourage scale and specialization. The main difference between healthcare and agriculture is that interoperability is essential for the former and will create cooperatives focused on data sharing just as in agriculture smaller providers have historically joined forces to achieve economies of scale and reduce redundant processes.

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MAGI and Insurance Exchange Strategies – Modified Adjusted Gross Income

In healthcare, the federal Patient Protection and Affordable Care Act (PPACA) introduces a new income definition—Modified Adjusted Gross Income (“MAGI”) for determining Medicaid income eligibility across the country. MAGI, pronounced the same way as the Biblical term, will be a regular figure in future accounts of who has access to the best prices for health care coverage and will be relevant for Insurance Exchanges ("HIX").

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ICD-10 Implementation Consulting Best Practices

One strategy is to continue to move ahead on ICD-10 process impacts, systems planning, and overall budgets but depending on readiness, get your consulting firm to help with both the requirements documentation and strategies for clinical documentation that don’t’ exist now. Why? The WEDI / NCHICA timeline suggests that health care providers should have started planning for ICD-10 about 18 months before the CMS announcement of a delay.

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ICD-10 Claim Date of Service Spans Mandate, Mapping ICD-10 to ICD-9 Auto Adjudication Questions Posted

In the ICD-10 Consortium social network this week, health plans posted questions regarding processing ICD-10 claims that have date of service periods that span the mandated timeline as well as an outreach to other health plans regarding the pros and cons of receiving an ICD-10 claim, mapping it to an ICD-9 to adjudicate it. Also, ICD-10 is expected to impact auto adjudication rates for plans.

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