by Caroline Fife, M.D. | Apr 1, 2026 | Fight the Good Fight, Healthcare Payment Policy
The 2026 Medicare Physician Fee Schedule (MPFS) included a one-year, 2.5% positive update for 2026 Medicare payment. It was better than nothing, but still does not come close to adjusting for inflation. (Physician payments are among the few sectors of medicine that do...
by Caroline Fife, M.D. | Mar 30, 2026 | Fight the Good Fight, Healthcare Payment Policy
I have blogged a lot about the boring topic of Medicare’s contract with Acumen to develop a cost measure for “non-pressure” ulcers (which means diabetic foot ulcers, venous leg ulcers, arterial ulcers, and “generic” chronic ulcers – surgical wounds and traumatic...
by Caroline Fife, M.D. | Feb 20, 2026 | Healthcare Payment Policy, Medicare Audits
By Caroline Fife and Lindsay Horst We’ve been asking you to download your Field Test report for the “non-pressure ulcer” Cost Measure. This issue is important because in the future, CMS can claw back Medicare dollars from a wound care practitioner based on their...
by Caroline Fife, M.D. | Jan 26, 2026 | Field Test Report, Healthcare Payment Policy, Quality Payment Program
This is an official CMS release: Upcoming Specialty Society Office Hours We are holding office hours with specialty societies and organizations to provide information about the upcoming field testing period. These office hours are intended as an informal opportunity...
by Caroline Fife, M.D. | Aug 14, 2025 | Fight the Good Fight, Healthcare Payment Policy
White House, Tech Leaders Commit to Create Patient-Centric Healthcare Ecosystem | CMS Health Technology Ecosystem | CMS “For decades, bureaucrats and entrenched interests buried health data and blocked patients from taking control of their health,” said HHS Secretary...
by Caroline Fife, M.D. | Jul 30, 2025 | Fight the Good Fight, Healthcare Payment Policy
I should leave the coverage interpretation to the professionals. I appreciate all of you who tell me when I make a mistake. Donna Cartwright — who is a genuine expert — provided corrections on that UHC policy: “Epifix and Grafix are the only amniotic...
by Caroline Fife, M.D. | Jul 9, 2025 | Fight the Good Fight, Healthcare Payment Policy
CMS has released Quality Payment Program (QPP) performance data for 2023. Under the QPP, payment “adjustments” (bonuses and penalties) occur two years after the “performance year,” so that 2023 scores impact a practitioner’s 2025 Medicare payments. It’s important to...
by Caroline Fife, M.D. | Jun 6, 2025 | Healthcare Payment Policy
A 2022 study in JAMA Association found that the Quality Payment Program (QPP) was “approximately as effective as chance in terms of identifying high versus low quality performance.” That’s a big “oops” when you can lose up to 9% of your Medicare billing based on your...
by Caroline Fife, M.D. | Jun 5, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight, Healthcare Payment Policy
There’s a new article in Health Affairs about “site neutral” payments that could change everything for hospital-based outpatient departments – and by that, I mean, possibly end them. However, I have been wrong about this threat for more than a decade – which means...
by Caroline Fife, M.D. | May 30, 2025 | Healthcare Payment Policy
I know you love reading about the Merit Based Incentive Payment System (MIPS) as much as I love writing about it… However, MIPS now matters to a lot more practitioners as wound care transitions into the office-based/mobile setting. (I will make a mental note to...
