Medical providers should be doing everything they can to get in front of the medical billing changes that are coming next year – and this starts with understanding what’s in the forecast for medical billing and medical billing services.
Some of these predictions have been talked about for years, but because of changes brought about by COVID, staffing shortages, and increased complexity in medical billing and coding, they’re primed to begin to take real hold in 2024. Here are the three main factors I see shifting the medical billing landscape over the next year.
Value-based care will increase the value of accuracy.
Value-based care has been slow to take hold but 2024 promises some changes that I believe will genuinely turn the tide. This is because of two initiatives that are set to launch next year.
First, there’s the Guiding an Improved Dementia Experience (GUIDE) Model, an effort to improve the quality of life for patients with dementia, reduce the strain on caregivers, and help people remain in their homes. CMS is testing alternative payment for participants and the implications for care coordination and management as well as home health care could be significant.
The second and possibly more impactful is the Making Care Primary (MCP) model. This voluntary model was announced this year and will be launching in eight states in 2024. This model could signal a new phase in adoption of value-based care since it is open to primary care physicians who don’t have experience in these types of payment models.
Recent changes will increase the ROI of outsourcing.
2024 will be a year where providers who understand the value of outsourcing will see increasing return on their investment. This is largely because of steadily increasing complexity of medical billing and coding.
For example, consider that next year, the new version of the CMS’ Hierarchical Condition Category (CMS-HCC) risk adjustment model is scheduled to roll out. This new model adds almost 30 payment HCCs, changes the names of others, and shifts mapping among other changes. This level of complexity means that providers who try to navigate medical billing and coding alone without evaluating the potential of partnership in their medical billing service will be at a distinct disadvantage.
Price transparency will increase the value of excellence in billing.
Patient expectations in billing have increased over the years, but with surprise billing legislation steadily taking hold, awareness of the importance of a positive billing experience is only increasing.
This means that patients are talking and that providers who prioritize investment in becoming a center of excellence in billing will be able to differentiate themselves from their competitors.
Hemant Apte, Chief Executive Officer in
Hemant Apte, Founder & Chief Executive Officer of 3Gen Consulting, is a seasoned executive leader with deep domain expertise in US healthcare management practices. He founded 3Gen Consulting in 2006 and has been instrumental in offering thought leadership to his clients and providing services and solutions that are unique in the market.