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This edition describes several key forces affecting all physicians: price transparency, private exchanges, ACA (“Obamacare”) impact and the growth of high deductible health care plans. These inter-related trends highlight how patients are being asked to take on a larger role in healthcare. At the same time, emergency departments continue to see many of the most vulnerable patients who are least equipped to respond.

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ICD-9 vs. ICD-10 Cardiomyopathy

Diagnosis: Cardiomyopathy   ICD-9 Code(s): 425.0 – 425.9 Listed Under: Diseases Of The Circulatory System 390-459 > Other Forms Of Heart Disease 420-429 > Cardiomyopathy 425- ICD-10 Code(s) I42.0 – I43 Listed Under: Diseases of the circulatory system I00-I99 > Other forms of heart disease I30-I52 > Cardiomyopathy I42- Diagnoses in shaded areas are titles only and are not...

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Price Transparency Takes Off

Many price transparency programs are maturing from providers, lobbying groups, insurers and the federal and state governments. It is increasingly possible for consumers to compare prices for procedures, episodes of care, and other medical services. We outline the trends and describe a number of ways patients can now access and compare healthcare price and quality information.

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The Health Insurance Exchange You May Not Have Heard About

Public insurance exchanges were introduced through the ACA. But emerging under the radar are private exchanges that employers are flocking to as a new way to offer health insurance for their employees. A private exchange is an online insurance marketplace, separate from the ACA’s public exchange, where employees are offered a wider array of health insurance coverage choices than in traditional job-based benefit plans. Eventually, these private exchanges may be as large or larger than the public exchanges.

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How Are Physicians Faring Under Obamacare?

It is still too soon to make a prediction about the impact of the ACA and health insurance exchanges on physicians. Some areas are moving along better than expected, such as manageable patient growth. Yet the growing pains of working with insurance exchange health plans is evident. The issues are more complex as patients have less understanding of what is covered and those insured for the first time need help understanding how their plan works. At the same time, according to MGMA and other surveys, rates and participation are not as problematic as many expected.

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How the New High-Deductible Insurance Plans May Affect Your AR

A recent reports found 17% of employers offering high-deductible plans as the only option to their employees in 2013 and 44 percent saying high-deductible plans would be the only option offered to employees in 2014. And, the most popular plans bought on the new ACA and private exchanges are those with low premiums and high deductibles. Physician practices need to make a number of changes to adapt to patients in these plans in order to reduce the risk of non-payment or increases in receivables.

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