All of the rapid changes facing rheumatology practice managers —government regulations, drug pricing, new biologic and biosimilar medications, insurance issues, and rules on reimbursement, to name a few — make it challenging to project future earnings and prioritize needs for practice viability.
This year’s Business/Administration track at the ACR/ARP Annual Meeting offers updates on all of these issues through programming designed to educate about new and evolving guidelines, laws, and regulations.
“The overarching theme this year is governmental regulation and legislation changes as well as insurance/pharmacy benefit manager’s utilization tools that burden providers and delay care and how to best overcome the hurdles and get involved,” said Elizabeth (Blair) Solow, MD, Assistant Professor of Medicine in the Division of Rheumatic Diseases at UT Southwestern Medical Center in Dallas, TX, and ACR Committee on Rheumatologic Care liaison to the Annual Meeting Program Committee.
New for 2019 is a RISE registry roundtable discussion that focuses on CMS changes to MIPS in 2019 and what it means for rheumatology practices. The “Practice Management Roundtable” takes place from 11:15 AM – 12:00 PM as part of the Premeeting Course Practice Matters: Navigate A Path to Success! From 7:00 AM – 4:15 PM. The course, which is a ticketed session and requires registration, also will highlight additional revenue streams for practices, including telehealth and infusion centers, updates in legislative and regulatory policies impacting coding and reimbursement, and strategies for practice workflow.
Dr. Solow also highlighted the following sessions for practice managers:
- Prior Authorization Nuts & Bolts (1:00 – 2:00 PM Sunday): This session will offer tips on successful prior authorization workflows and also describe the legislative and regulatory barriers and ways to tackle these complex issues that often frustrate providers, support staff, and practice managers, leading to burnout and delays in care.
- Keep Up with Insurance Changes: How They May Affect Patients (4:30 – 6:00 PM Sunday): Presenters will describe recent insurance changes and forecasting what is coming as well as offer communication tools for providers and managers to help guide patients.
- Raise Your Voice! Advocacy Update from Government Affairs (1:00 – 2:00 PM Monday): Attendees will learn about legislative and regulatory wins by the ACR Government Affairs Committee and discuss practical approaches to getting involved in issues that directly impact how we practice rheumatology.
- Get Paid: Update on MACRA, APMs and MIPS Tips (1:00 – 2:00 PM Tuesday). “This session is incredibly important as we move through changes in regulation on the MACRA legislation in its third reporting year and will give an update on the new RA APM being created by the ACR for members,” Dr. Solow said.
- Using the RISE Registry to Improve Practice & Research (9:00– 10:00 AM Wednesday): Presenters will discuss MIPS reporting and opportunities for quality improvement. Dr. Solow said that investment in this resource will be invaluable with coming reimbursement changes in value-based care.
- Reimbursement in Telehealth (11:00 AM – 12:00 PM Wednesday): This session will review the regulatory and legal standards for telehealth and discuss the right patients for this medium as well as expected revenue. “Telehealth is the future, and this session will highlight the success of two practices,” Dr. Solow said.
- How to Make the EMR Work for You (11:00 AM – 12:00 PM Tuesday): EMR is here to stay. This session may help managers and physicians be more efficient with the EHR, leading to opportunities for additional services offered to patients.