Value-based payments are shaking up the payment model, and providers will see a reduction in reimbursement for certain procedures, diagnoses and quality processes. However, Dallas-based MD Buyline proposes the changing payment model also presents opportunities for increased reimbursement in a number of clinical areas.
Here are 14 opportunities for reimbursement, presented by the highest and lowest reimbursement increase in each clinical area (when available), as identified by MD Buyline.
Inpatient Cardiology
Drug-coated stents: 0.08 percent to 3.05 percent
Cardiac pacemaker replacements: 12.84 percent
Outpatient Cardiology
Level implementation/revision/replacement of neurostimulator electrodes: 5.4 percent
Level II Cardiac Imaging: 40 percent
Radiation Therapy
Intensity-modulated treatment therapy treatment delivery: 6 percent
Level I stereotactic radiosurgery: 21.6 percent
Proton Beam Radiation Therapy
Level II proton beam radiation therapy: 43 percent
Nuclear Medicine/Molecular Imaging
Level II pulmonary imaging: 22 percent
Brain imaging, SPECT neuroimaging: 152 percent
Imaging
Level III diagnostic and screening ultrasound: 19 percent
Level I diagnostic screening and ultrasound: 29 percent
Inpatient Surgery
Cholecystectomy: 5 percent to 9 percent
Outpatient Surgery
Prostate cyroablation: 5 percent
Level III endoscopy upper airway: 72 percent
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