How Changes in the Medicare 2022 Physician Fee Schedule Align With Value-Based Care for FQHCs

To support these critical providers during the pandemic and afterward, The Centers for Medicare & Medicaid Services (CMS) has made some significant changes in the 2022 Physician Fee Schedule (Final Rule)1 that directly benefit FQHCs - and give these community health centers even more of an incen...

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Bibliographic Details
Published in:The Health Lawyer 2022-02, Vol.34 (3), p.21-24
Main Author: Hudson, Stephanie
Format: Article
Language:English
Subjects:
Accountable care organizations
Chronic illnesses
Chronic obstructive pulmonary disease
Codes
Coronaviruses
COVID-19
Disease management
Emergency medical care
Health care policy
Health facilities
Health services
Hospice care
Medicaid
Medicare
Pandemics
Patients
Primary care
Reimbursement
Telemedicine
Value-based care
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Summary:To support these critical providers during the pandemic and afterward, The Centers for Medicare & Medicaid Services (CMS) has made some significant changes in the 2022 Physician Fee Schedule (Final Rule)1 that directly benefit FQHCs - and give these community health centers even more of an incentive to embrace value-based care (VBC) for all of their patients. While Medicare may not make up a huge proportion of the typical FQHC payor mix, Medicare is hugely influential across the payor landscape: state Medicaid programs and commercial insurance companies often follow Medicare's lead in payment reforms, creating best practices shared between payor types. Proactive and comprehensive management of conditions such as diabetes, hypertension, and chronic obstructive pulmonary disease (COPD) can reduce readmissions and emergency room visits, control overall costs, and improve quality of life for patients. [...]this Final Rule, FQHCs were not allowed to bill for both types of services in the same month.9 Concurrent billing, paired with increases in reimbursement rates and new codes for certain CCM services, will allow FQHCs to more effectively wrap their arms around their chronically ill patients.
ISSN:0736-3443