2024 Medicare Updates: How It Can Impact and Benefit Healthcare Practices

Staying abreast of Medicare changes is crucial for keeping your practice operations and patient care services up and running.

This edition will guide you through the latest shifts in Medicare policies and how you can turn these changes into opportunities for your practice.

Major Medicare Changes and Their Impact

1. Risk adjustment payment policy

Risk adjustment payment policies were modified?in collaboration with expert clinicians to consider how well different conditions predict costs. One major update is the shift to the ICD-10 coding system.

If you're?not familiar, ICD-10 is the coding system?that's been?used across the?U.S.?healthcare system since 2015.

By aligning?MA?payments with this system, we're?making sure?that Medicare payments reflect the most current healthcare practices—just like other federal health programs.

Another update is?the use of?more recent data to tweak the risk adjustment model. This model helps predict medical costs more accurately by considering how certain conditions?are coded, which can vary?a lot.

Medicare?is focusing?on making this model spot-on to prevent?any?inconsistencies and ensure everything runs smoothly.

With these policies, more accurate payments will?be made, reducing incentives to select healthy beneficiaries and discriminating against sicker ones.

Additionally, CMS will continue to pay more?for individuals who are dually eligible for Medicare and Medicaid?than?those who are?not,?when they have the same diagnoses.

2. Increased coverage for mental health services

Medicare has extended its telehealth services for mental health and substance use disorders until December 31, 2024, allowing patients to receive care at home via two-way, interactive?audio-only?technology when necessary.

This flexibility accommodates those with technological limitations or preferences so they can access essential services. Hospitals must be equipped to provide audio-video services but can resort to audio-only based on patient needs.

Services provided from home will?be compensated?at the non-facility Medicare Physician Fee Schedule rate, and marriage and family therapists are included, broadly expanding access to comprehensive telehealth mental health services.

Mental health has often been a complex area for reimbursement. But with the new enhanced coverage, clinics like the Community Wellness Centers can now expand their mental health services, knowing that?the costs will be more reliably covered, allowing them to serve more patients better.

3. Integration of preventive and wellness services

Clinics can now integrate more preventive services like diabetes education and smoking cessation programs into their offerings through the expanded Medicare coverage that reduces the cost burden on?both?the practice and its patients.

Practical Steps for Medicare Updates Implementation

1. Integrate changes into practice operations

This?could be as simple as updating your practice's software systems to integrate seamlessly with new Medicare requirements. Maintaining?regulatory compliance and reducing administrative overhead.

2. Consider offshore staffing

By working with qualified and certified medical virtual assistants, our clients managed to offload their routine?tasks?such?as appointment scheduling and follow-up calls,?allowing their staff to focus more on patient care?and less on backend operations.

Conclusion

This adjustment means institutions like Medical Groups can now invest more in training residents and other in-house staff?to secure?a future generation of well-prepared medical professionals.

Likewise, the improved transparency measures can help practices avoid pitfalls in plan selections, making?sure?that they choose the options most beneficial?for their patient demographic and business model.

If you need support for Medical Billing and Claims and new Medicare updates to your practice, Phoenix Virtual Solutions can help you streamline your operations with tailored support. Book your free no-commitment call now to learn more .

Sources:

https://www.cms.gov/newsroom/press-releases/hhs-updates-2024-medicare-advantage-program-and-part-d-payment-policies

https://www.cms.gov/newsroom/fact-sheets/fact-sheet-2024-medicare-advantage-and-part-d-rate-announcement https://www.cms.gov/files/document/mln1986542-medicare-mental-health-coverage.pdf