The Centers for Medicare & Medicaid Services (CMS) recently released its proposed 2025 Medicare Physician Fee Schedule Proposed Rule, introducing significant changes to accelerate the shift towards value-based care. These developments present both challenges and opportunities for healthcare providers.
Let’s explore three critical changes in the 2025 Medicare Physician Fee Schedule Proposed Rule and how Persivia, Inc supports this transition.
1. Advanced Primary Care Management
CMS proposes new coding and payment for Advanced Primary Care Management (APCM) services. This bundle incorporates existing care management service elements, reflecting the essential components of advanced primary care delivery. The goal is to improve the quality of primary care, enhance care coordination, and encourage practice transformation – all crucial elements of value-based care.
2. Maintaining Telehealth Flexibilities
The Centers for Medicare & Medicaid Services (CMS) has announced plans to uphold essential telehealth flexibilities that were expanded during the COVID-19 public health emergency. These measures were introduced to ensure that individuals could continue accessing healthcare services remotely. With the temporary extension of these flexibilities set to expire at the end of 2024, CMS is actively assessing the impact of telehealth on access and quality of care. The proposals for this year aim to preserve certain critical flexibilities while furthering CMS’s commitment to enhance and broaden telehealth services where appropriate.
3. Advancing Specialty Care Models
CMS is exploring a potential specialty care model leveraging MIPS Value Pathways to increase specialist engagement in value-based care. Additionally, they’re proposing new coding and payment for cardiovascular risk assessment and management services. These changes aim to extend value-based care principles beyond primary care.
As the industry awaits the final rule, expected later this year, it’s clear that the future of healthcare lies in value-based care. With the right tools, healthcare providers can adapt to these changes and thrive in this new environment, ultimately leading to better patient outcomes and more efficient healthcare delivery.
Persivia: Transforming CMS Challenges into Opportunities
Persivia CareSpace® is an AI-powered, integrated healthcare platform developed over 15 years to automate and optimize various aspects of care management. Persivia’s CareSpace® analyzes patients’ longitudinal medical records in real time. The platform’s AI engine drives clinical and financial insights. It helps healthcare providers confidently navigate the complexities of value-based care, from implementing new care management workflows to leveraging advanced analytics for risk stratification. We continually monitor regulatory changes, ensuring our solutions align with the latest CMS guidelines.