Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Primary Care Services

Healthcare Consumerism Challenges Primary Care Business Models

April 6, 2017 - Primary care providers are facing significant and oftentimes conflicting challenges in response to two major healthcare trends: value-based purchasing implementation and the rise of healthcare consumerism, a recent Journal of Internal Medicine article stated. In the article, UPMC Health Plan’s Chief Medical Officer William H. Shrank, MD, explained that many primary care practices are...

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Healthcare Consumerism Challenges Primary Care Business Models

by Jacqueline Belliveau

Primary care providers are facing significant and oftentimes conflicting challenges in response to two major healthcare trends: value-based purchasing implementation and the rise of healthcare consumerism, a recent Journal of Internal Medicine...

Lean Primary Care Improves Physician Productivity, Costs

by Jacqueline Belliveau

A recent American Journal of Managed Care study showed that implementing a Lean primary care model resulted in operational cost reductions, physician productivity improvements, and higher patient satisfaction scores. “Our findings indicate...

More Primary Care Leads to Less End-of-Life Medicare Spending

by Jacqueline Belliveau

Regions with more primary care providers saw less Medicare spending on end-of-life care compared to areas with less primary care practices, a recent Annals of Family Medicine study found. Medicare spending during the last two years of life was...

AAFP: Primary Care Undervalued in Medicare Reimbursement

by Jacqueline Belliveau

CMS released updated physician fee schedule rates in November 2016, but the American Academy of Family Physicians (AAFP) recently contended that Medicare reimbursement rates for primary care providers are still lacking. In a letter to CMS, the...

How Broader Primary Care Teams Can Decrease Healthcare Costs

by Jacqueline Belliveau

Developing broader primary care teams that interact with specific patient populations can save healthcare costs and realize a return on investment, according to a recent PricewaterhouseCoopers (PwC) analysis. For example, a primary care team...

Primary Care Initiative Continues to Reduce Medicare Spending

by Jacqueline Belliveau

The Comprehensive Primary Care Initiative (CPC) continued to improve quality of care and reduce Medicare spending in 2015 even though the initiative has yet to generate net healthcare savings, according to an official CMS blog post. In the initiative’s...

AMGA Urges CMS to Release Claims Reimbursement Plan for CPC+

by Jacqueline Belliveau

The American Medical Group Association (AMGA) has called on CMS to release the claims reimbursement formula for the Comprehensive Primary Care + (CPC+) model, according to a letter sent to the federal agency earlier this week. The value-based...

HHS Awards $100M to Health Centers for Quality Improvement

by Jacqueline Belliveau

The Department of Health and Human Services recently granted over $100 million in awards to 1,304 health centers across the nation to help improve care quality and boost primary care services, according to the federal department’s website....

At-Home Service Value-Based Care Model Saves Medicare $10M

by Jacqueline Belliveau

A value-based care model designed to deliver at-home primary care services to patients who suffer from multiple chronic diseases has continued to improve beneficiary outcomes and reduce Medicare spending. Medicare saved $10 million during the...

Team-Based Primary Care Cuts FFS Healthcare Revenue by 2.5%

by Jacqueline Belliveau

As healthcare providers continue to transition to value-based care, many hospitals and physician practices have focused on how to improve care coordination and team-based approaches to improve patient outcomes and boost their healthcare revenue...

CMS Opens Enrollment for Value-Based Primary Care Model

by Jacqueline Belliveau

CMS has opened the application period for the Comprehensive Primary Care Plus (CPC+) model, a value-based reimbursement initiative for primary care physicians in 14 areas of the country. The application period will be open until September 15,...

HRSA Grants to Boost Healthcare Employment for Primary Care

by Jacqueline Belliveau

The Health Resources and Services Administration (HRSA) has announced over $149 million in awards to support healthcare employment efforts to increase the number of primary care providers, the federal agency announced. To help prepare the next...

CMS Proposes Medicare Payment Reform Rule for Primary Care

by Jacqueline Belliveau

In efforts to better support primary care physicians, CMS has announced a proposed Medicare payment reform rule that would improve payment accuracy for providers who treat chronically ill and medically complex patients. The rule would update...

CMS Allows Some ACOs to Join New Value-Based Care Model

by Jacqueline Belliveau

CMS has expanded the eligibility requirements in the Comprehensive Primary Care Plus (CPC+) model to include primary care physicians in certain Medicare accountable care organizations (ACOs), according to an updated fact sheet. Up to 1,500 primary...

Patient Scheduling Still Problematic at VA Medical Settings

by Catherine Sampson

In a perfect world, the Department of Veterans Affairs’ (VA) patient scheduling system works effectively so veterans are able to access primary care physicians easily. Unfortunately, many veterans continue to face extremely long wait times...

New Primary Care Model Embraces Value-Based Reimbursement

by Jacqueline Belliveau

This week, CMS announced its largest multi-payer initiative to improve primary care and introduce new value-based reimbursement models. The Comprehensive Primary Care Plus (CPC+) model aims to help practices transition from the “one-size-fits-all,...

Why Chronic Illness is Threatening the Healthcare Industry

by Jacqueline DiChiara

1 in 4 primary care physicians feel dangerously ill-equipped to successfully handle and coordinate care for some of their most challenging patients, such as those with chronic conditions, severe mental illness, and those in need of long-term...

How Physician Shortages Are Transforming Healthcare’s Future

by Jacqueline DiChiara

Just as Rome was not built in a day, neither is a doctor. Training a physician can take up to a decade; the Colosseum was perhaps ironically built in less time. With predictions of massive physician shortages gaining headway across the healthcare...

Is Primary Care’s Role Keeping Up with Health Demographics?

by Jacqueline DiChiara

Is primary care here to stay, but only if it receives a heavy-handed makeover? According to new research from PwC's Health Research Institute (HRI), redesigned primary care system is best apt to deliver top-notch value to demanding...

CMS Announced Success of Primary Care Transformation Pilots

by Ryan Mcaskill

The success of two pilot programs that focus on primary care transformation has CMS hopeful for prolonged change. To meet the quickly changing healthcare landscape, a number of organizations are running pilot programs to experiment with new payment...


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