Medicare Blog

how to mitigate reduced medicare payments

by Teresa Bailey Published 2 years ago Updated 2 years ago
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When you’re income is low, a subsidy can help reduce Medicare premiums and other costs. You can deduct certain medical expenses on your tax return. Deductible medical expenses include premiums you paid for Parts B, D, and Medicare Advantage. However, there are limits to this deduction.

Full Answer

How can I reduce my Medicare premiums?

Apr 08, 2022 · With the change, the 2022 reduction in Medicare payments stemming from the sequester would be about $2.9 billion, down from an estimated $4.7 billion if the full sequester were in place all year. In turn, the sequester would be scheduled to increase in 2030 (to 2.25% for the first half of the year and 3% for the second half).

What is a Medicare payment reduction?

Dec 23, 2020 · The bill also included changes to the 2021 Medicare Physician Fee Schedule, including two provisions which will mitigate the 10.2% reduction in Medicare’s payment rates (due to the 2021 conversion factor) included in the CMS final rule on MPFS. The bill provides:

How does an advantage plan reduce Medicare premiums?

Jan 20, 2020 · Medicare payments for emergency care have effectively decreased by 53% between 1992 and 2016, because the allowed amounts were dictated by the Balanced Budget Act and did not keep pace with inflation. The mean reimbursement for privately insured patients see in the emergency department has also declined from 77.7% to 65.7% during this same period.

Will Medicare payments to physicians decrease in 2022?

Apr 23, 2021 · IRMAA applies to Medicare Parts B and D and the impact is as follows: Part B. If your yearly income in 2019 (for what you pay in 2021) was. You pay each month (in 2021) File individual tax return. File joint tax return. File married & separate tax return. $88,000 or less. $176,000 or less.

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Why are payers so aggressive?

Payers have gotten more aggressive about analyzing claims with injury codes. They want to understand the whole story in order to determine who’s responsible for the injury and whether another party should be liable for the cost.

Is shrinking payer rates a contributing factor to reimbursement pressures?

It’s not just shrinking payer rates that are contributing to reimbursement pressures. Another major contributor are the high-deductible health plans that many payers are rolling out – where a more significant portion of the total cost gets shifted toward the patient.

How to market to seniors?

That said, even in today’s digital-focused society, traditional marketing efforts still have merit—especially when it comes to seniors. A few creative ways to market to offline include: 1 contributing to local newspapers or magazines, 2 running television or radio ads, 3 teaming up with a local news station to host a guest spot, and 4 expanding your professional and referral network.

Who is Melissa Hughes?

Melissa Hughes is a senior content writer for WebPT. As a trained award-winning journalist and a forever learner, she uses her passion for education and really bad puns to inform her writing—and ultimately to help rehab therapists achieve greatness in practice.

Do you have to have an account to leave a Google review?

Good news; you don’t have to have an account to leave a Google review! Patients can leave these reviews anonymously—which is an excellent option for any patients who don’t use Google.

How long do you have to wait to sign up for Medicare?

You can sign up for Medicare three months before your 65th birthday month. You then have a seven-month-long Initial Enrollment Period. There’s a financial motive to enroll during that time. In general, if you wait and sign up for Part B later, you will pay a late enrollment penalty.

Who is Lindsay Malzone?

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

What are some examples of life changing events?

Examples of life-changing events include retirement, divorce, and the death of your spouse.

Do you pay taxes on a Roth IRA?

If you contribute money to a Roth IRA or 401K, you pay taxes on the money when you put it in. But the income you earn is tax-free. In some cases, you can convert a traditional IRA or 401K to a Roth. If you contribute to a health savings account, your contributions AND the income from them aren’t taxed as long as you use them for healthcare.

Can you deduct Medicare premiums?

Deductible medical expenses include premiums you paid for Parts B, D, and Medicare Advantage. However, there are limits to this deduction. First, you must have enough total deductions to itemize your deductions rather than taking the standard deduction.Second, you cannot deduct all your medical charges.

What is the PACE program?

PACE. PACE (Program of All-inclusive Care for the Elderly) is a Medicare/Medicaid program that helps people meet health care needs in the community.

What is SSI benefits?

A monthly benefit paid by Social Security. SSI is for people with limited income and resources who are disabled, blind, or age 65 or older. SSI benefits aren't the same as Social Security retirement or disability benefits.

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Introduction

  • Payers have been throwing uppercuts and jabs (read: payment cuts and regulatory restrictions) at rehab therapists for years. Nowadays, PTs, OTs, and SLPs are experts of bobbing and weaving—sidestepping less-than-ideal payer policies like Muhammad Ali himself. But there’s always room to learn another thing or two about combating payment reductions, ...
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Medicare

  • Is it worth it for PTs to contract with Medicare anymore?
    That depends on your individual clinic finances and your payer mix. If you’re losing money when you treat Medicare beneficiaries, then no—it’s not worth it to contract with Medicare. Ultimately, your clinic is a business, and you need to bring in revenue with each and every patient. But if a m…
  • Will the cut increase back to 9% in 2022?
    The bill that reduced the 9% cut has a year-long shelf-life. So yes, it is possible that the full 9% cut will return in 2022—though it doesn’t have to. If rehab therapists successfully advocate against further cuts, they may be able to shift Medicare’s reimbursement trajectory in their favor.
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Therapy Assistants

  • How has the reimbursement reduction for PTA and OTA services impacted the job market for as…
    It’s tough to say, as the cuts have not officially taken effect. However, as Jannenga stated during the webinar, PTAs and OTAs play a valuable role in the clinic. Even with the rate reduction, there are opportunities to leverage assistants in order to increase overall patient volume—quite possib…
  • Do the PTA and OTA modifiers only apply to original Medicare, or do they also apply to Medicar…
    Medicare Advantage policies typically follow Medicare’s guidelines, but this may vary from plan to plan. Your best bet to find out if the modifiers are necessary is to reach out to the individual carrier.
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Marketing

  • What are your thoughts on advertising on Yelp instead of Google?
    Here’s what our resident paid advertising expert, Josh Golden, has to say: “There are a lot of different algorithm factors that go into both platforms.” Your budget, competition, and strategy are just a handful of the factors that will influence your ability to advertise successfully. That bei…
  • Can you elaborate on how to measure and manage NPS®?
    Tracking Net Promoter Score® (NPS®) is an easy way to gauge how your patients feel about your practice and see how likely they are to promote (or detract from) your business. All you have to do is ask your patients, “On a scale of 0–10, how likely is it that you would recommend [practice na…
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Culture

  • What are the components of an employee burnout mitigation program? Who in the clinic should …
    Addressing employee burnout should fall to either a clinic owner or HR director. Burnout mitigation programs will likely look a little different from clinic to clinic, as reasons for burnout will vary from setting to setting (e.g., some therapists may burn out from being overworked, while ot…
  • What are some ideas for employee recognition programs?
    Some clinics opt to implement formal recognition programs. This may include: 1. Naming an employee of the month (based on feedback from supervisors or even a full-staff vote); 2. Recognizing and rewarding employees who achieve certain certifications or complete continuin…
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Miscellaneous

  • What is the difference between mobile PT and home health therapy?
    When we discuss mobile physical therapy and home health therapy on the WebPT Blog, we often use the terms interchangeably as the two are functionally the same. If we’re getting technical, “mobile PT” simply refers to the mode of delivery (i.e., physical therapy that can be delivered any…
  • Can providers accept cash from patients even when the providers are in-network with the patien…
    Probably not. Many preferred provider agreements prohibit in-network providers from offering cash-pay services to covered patients. If you want to provide cash-pay services to a patient who’s covered by an in-network provider, your best bet is to check your individual contract to see what …
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