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Current Trends in Health Care Reimbursement

With all of the changes made to the health care system in the United States within the last couple years, health care reimbursement has been a particularly hot topic. Here are some of the biggest trends in health care reimbursement within the industry today:

  • Ending of the fee-for-service structure. While there is still a fairly sizeable percentage of health care providers operating under the old fee-for-service model, under which providers receive payments for all tests and procedures, whether or not they were pertinent to the patient. However, this method has a lot of issues with profitability, and more and more provider are moving away from this outdated model of service.
  • Bundled payments. More providers are seeking bundled payments, in which they get the money they need to provide a standard procedure or treatment up front. This is particularly useful in specialized areas of service, but might not be as sensible for providers handling more general patients in primary care.
  • Accountable Care Organizations. ACOs are set up to provide more well coordinated patient care and to provide more cost savings for health care providers. As this is a relatively new trend, it’s difficult to say what its long-term viability is.
  • New technology. Technology is one of the fastest-growing industries affecting health care today. It’s providing new methods of patient coordination, tracking medical records, creating better standards of communication and more.
  • The rise of Medicare Advantage plans. Through Medicare Advantage plans, beneficiaries get health care coverage as long as they adhere to a narrow network of health care providers. To be a part of this network with Medicare, providers must submit quality reports every quarter, and then they will receive a rating on a five-star scale through Medicare.

Health care reimbursement and the overall health care industry in general will continue to evolve in the coming years. To stay up-to-date with the latest news and regulations, seek the advice of a skilled New Jersey health care reimbursement attorney at Buttaci Leardi & Werner, LLC.

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  • Posted on: Oct 30 2014