Amendments to Physician Fee Schedule Benefit Health Care

To safely, timely and efficiently help patients, health care providers rely on rules established by the government and medical organizations. As society changes and new discoveries come to light, those regulations need to reflect research and trends to allow for doctors to provide premium care. The most recent proposal – the 2016 Medicare Physician Fee Schedule – from the U.S. Centers for Medicare and Medicaid Services considers costs of medical equipment, updates payment rates and policies and sets standards for electronic health record software.

More realistic estimates for PACS
Picture archiving and communications systems have simplified the jobs of diagnostic radiology professionals. Not only do these programs store the files from medical imaging tests, but they also make it easier for health care providers to access the pictures. The software is always improving to add new imaging formats and simplify the process to look at patient information.

However, PACS cost money, along with the implementation and training programs that go with them. The previous method – estimating the price of a desktop computer – for determining expenses for the systems was inaccurate in regards to PACS, and this resulted in low physician reimbursements and Medicare payments, members of the Radiology Business Management Association said in a statement. With the 2016 Medicare Physician Fee Schedule, the CMS looked at invoices from digital imaging professionals and determined that the costs of PACS was more than double its estimates – $2,501 to $5,557. While the rule does not solve every problem, its proposed changes will begin the movement toward more accurate payment rates.

"The RBMA had consistently held that the $2,501 amount was inappropriate because a desktop computer is not equivalent to a PACS workstation, which is a more complex and expensive system," Liz Quam, chair of RBMA's Federal Affairs Committee, said in the release. "This is a step in the right direction, but not the ultimate solution."

EHR interoperability nearing
If the proposed 2016 Medicare Physician Fee Schedule is passed, amendments will also be coming to Medicare's EHR Incentive Program. Rural health clinics and federally qualified health centers will be required to enter any information related to demographics, medications, health conditions, clinical summaries and allergies into the EHR to help them communicate and collaborate with other providers. Certified EHR software must also be updated from year to year to ensure various systems can connect with one another.

For eligible professionals participating in the comprehensive primary care initiative, reporting guidelines for electronic clinical quality measures under Meaningful Use may also experience changes. Instead of at least nine CQMs across two domains, they will need to complete at least nine across three domains. Participants in the first year of the program may also be allowed to submit their reports via the CPC group instead of through the Registration and Attestation System.

With the 2016 Medicare Physician Fee Schedule, medical professionals should find it easier to collaborate with other EHR systems and to receive payments for performing digital imaging on Medicare beneficiaries. The proposed guidelines will streamline the reporting process and ensure patients receive the care they need.

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