Healthcare Snapshot

July 2023

CMS Releases 2024 Medicare Physician Fee Schedule (MPFS) Proposed Rule

In mid-July, CMS released the 2024 Medicare Physician Fee Schedule (MPFS) proposed rule. The proposed rule includes many changes that both PSW leadership and industry advocacy groups have advocated for on behalf of ACOs. The comment period for the proposed rule is now open and comments are due by September 11.

Some of the key changes included in the proposed rule are:

• The introduction of the new V28 Risk Adjustment Model.
• Adds several codes to the definition of primary care services for beneficiary assignment.
• Request for comments on an Enhanced Plus track within MSSP.
• Creates Medicare CQMs, a new quality reporting option for MSSP ACOs to report only on Medicare beneficiaries.
• Proposal to calculate QP determinations at the individual level, not APM entity level.

PSW will continue to review the MPFS proposed rule alongside our advocacy partners to prepare comments for submission. To view the 2024 MPFS proposed rule, click here.

A PSW Social Worker reached out to a patient who had over seven Emergency Department (ED) Visits in the past six months. The patient's ED Visits were for a number of reasons including chest pain, numbness in the hands, and an elevated heart rate. These symptoms began after a serious COVID-19 infection last year. The patient also experiences severe anxiety, amplifying their physical symptoms.

The patient has seen multiple specialists, but has been unable to get a diagnosis for their condition. They became discouraged and began to lose hope as they were unable to work due to their systems. However, PSW's Social Worker was able to work with the patient on awareness of their anxiety and its connection to physical symptoms.

PSW is now working to find a therapist who specializes in somatic therapy and was able to help the patient get a last-minute appointment with an internal medicine doctor. The patient said that they felt instant relief after their first appointment and felt so much gratitude for the PSW Social Worker's help. The patient still does not have a definitive diagnosis, but they felt validated and listened to by this new provider. The patient continues to receive services from PSW, has not had an ED Visit in the last month, and now gets to go back to work.