During a podcast, “Recent E/M Changes and Highlights from the 2024 MPFS Final Rule,” Principal Valerie Rock, along with Kristin Bohl, Member, Bass Berry & Sims PLC, discuss social determinants of health (SDOH) and the increased use of community health workers (CHW) related to policies finalized in the 2024 Medicare Physician Fee Schedule (MPFS) final rule. They also presented on the subject at the recent AHLA 2024 Institute on Medicare and Medicaid Payment Issues.
Community health workers build the capacity of the healthcare system, Rock explains, and are being called upon to help Medicare close the gap in health equity through SDOH. As Medicare enforces its new requirements related to SDOH and value-based care, physicians should properly account for the services of CHW and ensure compliance with guidelines from the Centers for Medicare & Medicaid Services.
Rock and Bohl also discuss Community Health Integration (CHI) services and Principal Illness Navigation (PIN) services and the role they play with SDOH. With CHI and PIN, “the level of service the CHW will provide is very comprehensive,” Rock says. “It is a kind of extender type of service” from someone embedded in the community that is meant to ultimately result in better care for patients.
Additionally, Rock and Bohl provide tips related to SDOH needs vs. services provided, the value of communication, proper documentation for care, use of outpatient settings, insourcing and outsourcing CHW services, and more.
The podcast was hosted by the American Health Law Association (AHLA) on July 12. AHLA’s Speaking of Law podcast series provides “commentary on the legal and policy issues affecting the American health care system,” according to its website.
PYA is proud to continue its longstanding relationship with AHLA by supporting thought leadership sponsored by the organization.
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