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PMMC Healthcare Revenue Cycle Blog
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CMS | Patient Estimates | Price Transparency
CMS Price Transparency Updates for 2024: Navigating Compliance, Avoiding Fines
The Centers for Medicare & Medicaid Services’ (CMS’s) initial price transparency rule went into effect on January 1, 2021. While January 1st, 2024, marks the three-year anniversary of this sweeping regulation, the rule is still evolving, and compliance is proving to be an ongoing challenge for many organizations. If your organization hasn’t yet achieved full compliance, fines are avoidable. However, you can mitigate the scope and severity of fines by prioritizing key updates to your pricing strategy. CMS regulators will be evaluating your organization to determine whether it has made a good-faith effort to achieve price transparency. They will also be evaluating your website to ensure it has the appropriate text file and footer link. Join us as we further explore these requirements, the fining process, and what you can do to protect your organization’s revenue in 2024. We’ll also highlight what changes go into force in 2024, what key deadlines to look out for, and what they mean for you.
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Pricing Transparency Evolves: Ensuring Hospital Compliance Amidst New Regulations
In July 2023, CMS proposed some major price transparency changes with the release of the 2024 OPPS rules. Most notably, the proposed rule changes move to standardize the formatting of the machine-readable files (MRF), increase data accessibility and greater accountability. This can lead to a significant impact on hospitals that are not completely compliant with existing regulations. Even if you believe your organization is 100% compliant today, the proposed changes may expose your hospital to penalties. Let’s examine the proposed price transparency changes and highlight how PMMC is quickly moving to incorporate these changes to help our clients remain compliant.
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Examples of Online Patient Estimates to Help Your Hospital with Price Transparency
At a time when healthcare consumers expect greater personalization when it comes to receiving price estimates, providers are feeling the pressure to improve price transparency by providing an online patient estimation solution that is engaging, easy to use, and most of all, accurate.
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CMS Delays Cardiac Bundles, But Now is The Time To Plan
Due to complications with timing, the Centers for Medicare and Medicaid Services (CMS) has delayed implementation of the three new episodic payment models (EPM) and Cardiac Rehabilitation (CR) incentive program until January 1, 2018.
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CJR Model | CMS | bundled episodes
A New Era for Hospital Finance: Being Accountable for Things Beyond Your Control
Significant Changes Coming - Get Ready Now On November 16, 2015, The Department of Health and Human Services (HHS) announced that CMS has approval for the final rule for the Comprehensive Care for Joint Replacement (CJR) Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services . It will be applicable in April 2016. CJR is the first mandatory bundle model, and it represents the prototype for massive change in healthcare finance that will take place in the next two years.
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It's Official: CMS Finalizes Mandatory Bundled Episodes Initiative
As expected, the Centers for Medicare & Medicaid Services (CMS) finalized the Comprehensive Care for Joint Replacement (CJR) model, which will hold hospitals accountable for the total quality of care they deliver to Medicare beneficiaries for hip and knee replacements from surgery through recovery. The announcement came in a news release on Monday.
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The Alphabet Soup of the New CMS Bundled Episode Model
The Centers for Medicare and Medicaid Services (CMS) loves to use acronyms and there’s quite a few related to its new CCJR bundled episode payment model. For healthcare finance professionals, it’s easy to lose sight of some of these, so we’ll recap and break them down with definitions:
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CMS | Comprehensive Care for Joint Replacement Model | bundled episodes
Ready or Not, CMS says Go: Hospitals to Manage Episodes of Care
By now, most healthcare finance leaders are at least familiar with the recent CMS Comprehensive Care for Joint Replacement (CCJR) Model. This is a really big deal for healthcare providers. Let’s start with the basics:
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