NFMGMA November 2013 Educational Session – Elizabeth Woodcock’s State of the Industry: The Challenges – and Opportunities – that Lie Ahead for Physicians in 2014

Elizabeth Woodcock – Woodcock & Associates

by Richard Stokes

Yes, that’s right everyone, it’s officially November.  Thanksgiving and Christmas are right around the corner and Elizabeth Woodcock of Woodcock & Associates is back to talk to us about what lies ahead for physicians in 2014.  If you’ve never seen Elizabeth speak – you’re in for a treat.  She’s got loads of great information to share and is extremely knowledgeable in the healthcare arena, so trust me when I say it’s going to feel like you’re “drinking from a fire-hose!”

Elizabeth says that it’s very easy to get caught up in the Affordable Care Act and focus on all the questions and uncertainty surrounding that, but you can’t overlook the significant factors that will influence physician reimbursement for 2014.

Some of the topics she’ll explore are:

  • Sequestration – the controversial cuts to federal programs applied to Medicare reimbursement in April 2013 that will continue through 2021.
  • Medicare’s Electronic Prescribing (eRx) Incentive Program – for those who chose not to participate or who failed to successfully do so, reimbursement of all Medicare Part B claims will be adjusted downward by 2% in 2014.  Elizabeth will tell you what to look for to determine if your claims are ‘taking a hit.’
  • The EHR incentive program – while payment adjustments won’t yet be applied, 2014 is the final year to circumvent them.
  • The Physician Quality Reporting System (PQRS) – will impose its initial penalties of a 1.5% reduction in Medicare Part B reimbursement in 2015 based on performance in 2013.

Other initiatives that are also in the works and will affect reimbursement both positively and negatively are: 

  • The Physician Feedback/Value-Based Modifier Program – A program that evaluates the performance of medical groups of 100 or more physicians and applies penalties (and bonuses).  The news here is that CMS is proposing to expand the program to groups of 10-99 physicians next year.
  • Medicare program changes – Some may lead you to consider untying any contracts that you have with commercial payers that hinge on Medicare rates.
  • Pay-for-performance – New reimbursement models that reward physicians for meeting stipulated performance measures.
  • Primary Care Incentive Program (PCIP) and General Surgery Incentive Program (GSIP) – Programs that provide eligible physicians and advanced practice providers with a quarterly payment for select services provided to Medicare beneficiaries.

These are just some of the key topics that Elizabeth will be addressing so get a good night’s rest and come prepared to ask questions.

Medicare was never easy to understand, and as Elizabeth says it now becomes an even more complex program to navigate.

Here are some links if you want to do your own research on the topics that Elizabeth will be presenting on: 

  • Centers for Medicare & Medicaid Services Programs

Electronic Prescribing (eRx) Program

  • Physician Quality Reporting System (PQRS)

  • Electronic Health Record (EHR) Incentive Program

  • Primary Care Incentive Program (PCIP) 

  • General Surgery Incentive Program (GSIP)_ 

  • Example: Tennessee’s “rate parity” program for office visits and vaccine administration

This is going to be an extremely informative session so you don’t want to miss it.  If you haven’t already registered, what are you waiting for?  Feel free to share this with your peers and colleagues and invite them to attend as well.  North Fulton MGMA


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