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8 / 3 / 2023

Mental Health Changes V24 to V28

By
Amy Crenshaw-Pritchett
While mental health awareness month occurred in May, we need not forget the upcoming changes to Medicare Advantage members in CY 2024 and beyond. On March 31, 2023, The...
8 / 3 / 2023

Proposed Rule Summary of Topics and Interesting Points: Physician Fee Schedule 2024

By
Kelly Loya &
Lori Carlin &
Amy Crenshaw-Pritchett
Pinnacle has reviewed the proposed rule changes for CY2024 related to the Medicare Physician Fee schedule.  CMS has also published a fifteen (15) fact-sheet summary.  The condensed overview below...
8 / 1 / 2023

Every PCP Should Be In a Shared Savings Contract: Where do we start?

By
Curtis Bernstein &
Kelly Conroy &
Daniela Yusufbekova
In a time where healthcare costs continue to rise, there is a diverse range of payment models in use, ranging from traditional fee-for-service to global capitated payment, to stunt...
6 / 26 / 2023

Modifier 25: Is Your Documentation Up to Par?

By
Lori Carlin
Modifier 25 Scenarios Is your documentation up to par to support Modifier 25? First, you should read The Center for Medicare and Medicaid Services (CMS) National Correct Coding Initiative...
6 / 21 / 2023

Medicare’s Change to the Split/Shared Billing Rules: Implications for Physician Compensation Planning

By
Jodi Nayoski
1.  What is a split/shared service? This term refers to evaluation and management services that are performed partly by a physician and partly by a non-physician practitioner (NPP) who...
6 / 14 / 2023

As CMS Focuses on Quality, there are Monumental Changes to Reimbursement for Quality on the Horizon!

By
Amy Crenshaw-Pritchett
The Centers for Medicare and Medicaid Services (“CMS”) utilize risk adjustment factors to estimate the cost of Medicare Advantage (“MA”) beneficiaries and those associated costs of providing care.  Risk...
5 / 3 / 2023

Non-Compete Contracting in Healthcare: Potential Impact on Physician Contracting and Alignment

By
David White
& Carlo Duaban
& G. Christopher Louis
Introduction A covenant not to compete (a.k.a. a non-compete agreement) is a contract or clause in a contract specifying that an employee or contractor (often through a professional services...
3 / 14 / 2023

Tele-Nephrology – The Future is Now

By
David White
In recent years, the healthcare industry has seen a surge in the use of telehealth services, and nephrology is no exception. Remote nephrology, or tele-nephrology, involves the use of...
2 / 22 / 2023

PHC 3rd Quarter 2022 Real Estate Newsletter

By
Mike Vandaveer
& G. Christopher Louis
&
The Pinnacle Real Estate Group consists of a combination of professionals who use their extensive experience in both valuation and transaction services within the healthcare real estate industry to...
2 / 21 / 2023

CMS Changes ACO Application Cycle! Are You Ready?

By
Kelly Conroy &
Zach Maher &
Daniela Yusufbekova
The Centers for Medicare and Medicaid Services finalized changes to the 2023 ACO application cycle steps and timelines. After collectively submitting 50+ successful applications, Pinnacle is excited to continue...