Initial analyses of “What the Medicare data reveal about mental health services” were previously reported here. Watch this page for updates on information developed from the “Medicare Provider Utilization and Payment Data: Physician and Other Supplier” data released by CMS April 9, 2014. The data allow insights into health services provided to Medicare Beneficiaries in 2012 …

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Associated with a great deal of fanfare, particularly in the popular press, on April 9 Medicare released data about how much it paid physicians and other suppliers in 2012. Popular reporting quickly focused on the “top billers” to Medicare for health services, including setting up “look up your own doctor” type of search websites. Who …

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Modern Healthcare is reporting that a bipartisan deal has been struck that will fix the Medicare SGR problem. The proposed solution will replace the SGR with a 0.5% annual increase in reimbursement from 2014 through 2018, and then move toward an incentive payment model that will incorporate  the current PQRS system, value-based payment and “meaningful …

Continue reading ‘The Fix Is In: Medicare May Soon Become the Most Stable, Predictable Payer’ »

On 12/23/2013, Medicare announced 123 new Accountable Care Organizations, covering approximately 1.5 million more Medicare beneficiaries. The list of new ACOs may be found here: ACOs with start date 1/1/2014. Lists of ACOs previously announced are here: Start date April 1, 2012 (27 ACOs, ~375,000 beneficiaries in 18 States) Start date July 1, 2012 (87 ACOs) Start date January 1, 2013 (106 ACOs) With the …

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By and large, health professionals are not supposed to talk to each other about how much they charge. In theory, this is because they might “conspire” with each other to only charge a certain amount. The supposed risk to consumers is there will be no “competition” among health professionals, that prices will be driven up, …

Continue reading ‘How much should your therapist be charging for your services?’ »

Now that Congress has finally decided what doctors will be earning this year when they see Medicare beneficiaries, here is a look at what is happening to reimbursement for mental health care. The following graphs show actual changes in reimbursement for psychologists to perform initial evaluations, to provide 45 to 50 minutes of therapy, and …

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