MPFS Final Rule Cuts Physician Payments:

Will It Last?

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2025, aiming “to strengthen primary care, expand access to preventive services, and further access to whole-person care.” While the finalized fee schedule cuts payments to physicians, Congress is considering legislation to override the cut. This Health Capital Topics article discusses the provisions contained in the MPFS final rule, as well as the proposed “doc fix” legislation. (Read more...)

OPPS Final Rule Issued by CMS

On November 1, 2024, CMS released its Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule for calendar year 2025. The rule finalizes payment updates, revises current programs, and establishes new standards to address the ongoing maternal health crisis. This Health Capital Topics article discusses the key OPPS changes and updates included in the Final Rule. (Read more...)

Record-Breaking Savings for ACOs in 2023

On October 29, 2024, CMS announced Performance Year (PY) 2023 results for accountable care organizations (ACOs) participating its Medicare Shared Savings Program (MSSP). Notably, MSSP ACOs garnered the largest net savings in MSSP’s history – more than $2.1 billion. This Health Capital Topics article discusses MSSP performance in 2023 and how this may inform value-based care going forward. (Read more...) 

Valuation of Hospitals: Technological Environment

Technological advancements have accelerated the shift of healthcare services from inpatient to outpatient settings, creating both opportunities and challenges for hospitals. For instance, minimally invasive procedures often serve as alternatives to traditional, more invasive surgeries. Additionally, the integration of telehealth and artificial intelligence (AI) has the potential to enhance access to and quality of care while reducing expenditures and administrative burdens. This final installment of a five-part series on the valuation of hospitals examines the technological advancements transforming the industry. (Read more...) 

HCC’s Todd Zigrang and Jessica Bailey-Wheaton, were recently published in the Fourth Quarter 2024 issue of St. Louis Metropolitan Medicine. This article discusses recently announced MA market exits, the reasons for those exits, and the current environment in which MA plans are operating.

For more recently published material written by HCC, please visit www.healthcapital.com

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A recent HCC authored article entitled "Valuation Standards in Healthcare" was published by the National Association of Certified Valuators and Analysts (NACVA) in the September/October issue of The Value Examiner.

For more recently published material written by HCC, please visit www.healthcapital.com

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