CVS Aquires Aetna, to create CVS Healthcare.

Recently, the Wall Street Journal, in a front page article, addressed the pending acquisition of Aetna by CVS Healthcare.
The piece focused on the panic that the deal is causing many healthcare players. They’re concerned over the combination of a giant retail delivery platform, the CVS stores, with the health insurance, managed care, and huge patient database of Aetna.

ASC procedure volume and length benchmarks (CDC data 2010)

There are around 48.3 million surgeries performed in ASCs per year, and 70 percent were associated with the digestive system, musculoskeletal system, integumentary system and nervous system, according to a report from the CDC. 

CMS reduces Colonoscopy Reimbursement in 2018

The 2018 Medicare Physician Fee Schedule reduces the base unit value for screening colonoscopy from 5 to 3, this represents a 40% reduction in base units for the procedures that translates into an estimated 28% reduction in reimbursement, based on an average of 7.2 units billed.

CMS will cancel major bundled payment initiatives

CMS has proposed canceling the cardiac and expanded joint replacement bundled payment models.

The rule, which was sent to the Office of Management and Budget last week, would cancel the mandatory bundled payment programs for heart attacks and bypass surgeries as well as expansion of the existing Comprehensive Care for Joint Replacement model to include surgical treatments for hip and femur fractures. Those bundled payment initiatives have already been delayed twice. They’re currently slated to take effect Jan. 1, 2018.

CMS Releases 2017 Measure Specifications for the Merit-Based Incentive Payment System

The Centers for Medicare & Medicaid Services (CMS) released measure specifications for the 2017 transition year for the Merit-Based Incentive Payment System (MIPS). Measure specifications are available for download here. Members are encouraged to review measures applicable to their practice as they prepare to participate in quality reporting under MIPS.

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