Several factors, including supply chain costs and competitive pressures, make it harder for independent pharmacies to realize profits and growth. From 2016-2022, the average independent pharmacy gross profit margin was 20.8% to 21.1%.

Increased economic pressures squeeze health plans, and providers seek relief from burnout and revenue loss while wanting to improve outcomes. Both parties are looking for ways to achieve cost reductions, enhance quality, and better the healthcare experience.

Medicare now covers an optional screening for social determinants of health (SDOH). As detailed in the 2024 Physician Fee Schedule Final Rule, this assessment can be conducted during an Annual Wellness Visit (AWV).

Medicare permits healthcare organizations to subcontract care management services.

For 2024, Medicare has introduced a new Social Determinants of Health (SDoH) assessment. An SDoH assessment is a valuable tool to help to identify known or suspected SDoH needs that may interfere with the diagnosis or treatment of a patient and can help lead to improved outcomes.

With an Annual Wellness Visit (AWV), your patient receives an appropriate opportunity to review Advance Care Planning (ACP). You can use this yearly assessment as a time to cover why advanced planning can be of great benefit. In this video, we discuss everything you need to know about the 2024 CPT codes, billing requirements, and reimbursements for Advance Care Planning (ACP), so you can properly bill for this program and maximize your revenue. This includes code 99497 and add-on code 99498. Download an Advance Care Planning guide to help you manage your program.

The National Committee for Quality Assurance (NCQA) is a private, nonprofit organization that helps health plans and provider organizations improve care quality and measurement.