The ACA also brings about changes in payment and care models. A few of the biggest ones right now are the fee-for-value service models replacing conventional fee-for-service programs. The government has been pushing providers to adapt these new service models via Medicare and Medicaid, mainly by promoting accountable care organizations (ACOs), patient-centered medical homes (PCMH), and the like.
The impending shift to ICD-10 is also a critical development. Upon its implementation on October 1, the coding system will directly affect electronic health records systems and analytics tech, on top of coding and reimbursement rates and billing. Organizations that have yet to develop a plan of action for the ICD-10 shift are in deep water as they may experience payment delays and slowdowns in hospital revenue cycle management processes.