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

Value Based Care

Coalition Offers CMMI, Alternative Payment Model Improvements

February 16, 2017 - Thirty-five healthcare industry groups recently banded together to offer the newly-approved Department of Health and Human Services (HHS) Secretary a set of guidelines for CMS Innovation Center (CMMI) and alternative payment model development improvements. The healthcare coalition, which goes by the Healthcare Leaders for Accountable Innovation in Medicare, contains industry leaders such as...


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Coalition Offers CMMI, Alternative Payment Model Improvements

by Jacqueline Belliveau

Thirty-five healthcare industry groups recently banded together to offer the newly-approved Department of Health and Human Services (HHS) Secretary a set of guidelines for CMS Innovation Center (CMMI) and alternative payment model development...

HHS: Physician Self-Referral Law Hinders Value-Based Care

by Jacqueline Belliveau

Some healthcare fraud prevention regulations many impede value-based care models that use financial incentives to encourage providers to improve care quality and reduce healthcare costs, the Department of Health and Human Services (HHS) recently...

Industry Orgs Urge Lawmakers to Continue Value-Based Care Push

by Jacqueline Belliveau

Over 120 healthcare industry groups, including hospitals, healthcare systems, payers, and professional organizations, recently urged the Trump administration and Congress to not discontinue or slow the transition to value-based care. In the letter...

359K Clinicians to Join CMS Alternative Payment Models in 2017

by Jacqueline Belliveau

CMS recently announced that the federal agency selected over 359,000 clinicians to participate in four of the federal agency’s alternative payment models in 2017. The new participants will be joining the Medicare Shared Savings Program...

Avoidable Hospitalizations Drop 31% for Long-Term Care Patients

by Jacqueline Belliveau

Avoidable hospitalizations among dual-eligible long-term care facility residents dropped by 31 percent between 2010 and 2015 largely because of value-based care programs, CMS recently stated in an official blog post. “Family members want...

Do Pay-for-Performance Programs Improve Patient Outcomes?

by Jacqueline Belliveau

Value-based reimbursement models that pay for performance modestly incentivized providers to stick to clinical guidelines, but they may not be linked to better patient outcomes, a recent Annals of Internal Medicine study indicates. The literature...

Addressing Social Risk in Medicare Value-Based Reimbursement

by Jacqueline Belliveau

Hospitals that disproportionately treat patients with social risk factors, such as low income and race, may be unfairly penalized under some Medicare value-based reimbursement programs. But the National Academies of Science, Engineering, and...

Payment Reform, Value-Based Care Top 2017 Medicaid Priorities

by Jacqueline Belliveau

Delivery system and healthcare payment reform, especially through value-based care, topped the list of 2017 Medicaid priorities, according to the annual State Medicaid Operations Survey from the National Association of Medicaid Directors (NAMD)....

CMS Adds 2 Compare Websites to Boost Healthcare Transparency

by Jacqueline Belliveau

In effort to increase healthcare transparency, CMS recently added two new healthcare organization Compare websites and updated performance data for existing hospice care, hospital, and physician Compare websites. “At CMS, one of our top...

Developing Post-Acute Networks for APM Reimbursement Success

by Jacqueline Belliveau

About 85 percent of healthcare C-suite leaders expect to expand post-acute care partnerships over the next three years, especially as their organizations aim to maximize alternative payment model reimbursement, a recent Premier report found....

Provider Orgs Seek Healthcare Costs Tools for Value-Based Care

by Jacqueline Belliveau

Provider organizations are increasingly looking to implement healthcare costs tools to better manage healthcare supply chain costs under value-based care models, a recent Black Book Market Research survey stated. The survey of 1,158 healthcare...

HHS Sec. Burwell Shares Vision for Value-Based Care Future

by Jacqueline Belliveau

In a recent Health Affairs blog post, HHS Secretary Sylvia Mathews Burwell called for value-based care progress after the Obama administration ends through more alternative payment models, care delivery transformation, and health data access....

GAO Finds Value-Based Care Issues for Small, Rural Practices

by Jacqueline Belliveau

A recent Government Accountability Office (GAO) report found that small and rural practices faced several challenges with implementing value-based care models, such as limited financial resources, a lack of interoperable health IT, population...

Value-Based Care, Hospital Revenue Cycle Lead Top 2016 Stories

by Jacqueline Belliveau

From the final MACRA implementation rule to new value-based care initiatives, 2016 certainly did not leave healthcare providers bored at their desks. Instead, providers were busy digesting changes to reimbursement structures and researching ways...

AMGA: Value-Based Reimbursement Transition Slower Than Expected

by Jacqueline Belliveau

Fee-for-service revenue decreased by more than 20 percent as value-based reimbursement payments increased, reported the American Medical Group Association (AMGA). But the transition to value-based reimbursement may be slowing down compared to...

Value-Based Care, Price Transparency Drive Hospital Mergers

by Jacqueline Belliveau

Healthcare system and hospital mergers will likely increase as new value-based care models emerge, according to a recent Healthcare Financial Management Association (HFMA) report. But the rise in value-based reimbursement and price transparency...

Slavitt Offers Value-Based Care Steps Post MACRA Implementation

by Jacqueline Belliveau

As CMS gets ready for MACRA implementation in the new year, CMS Acting Administrator Andy Slavitt urged healthcare and political leaders to carry on value-based care progress made under the Affordable Care Act. In a statement at the MACRA MIPS/APM...

AHA Calls for Value-Based Reimbursement Reform Under Trump

by Jacqueline Belliveau

In a recent letter to President-Elect Trump, the American Hospital Association (AHA) urged the upcoming administration to continue the value-based reimbursement transition by developing more effective alternative payment models, promoting telehealth,...

Using an Alternative Payment Model to Reduce Hospitalizations

by Jacqueline Belliveau

Are clinical interventions enough to alter provider behavior to align with value-based care? Or are providers more motivated to change because of financial incentives under alternative payment models? CMS recently partnered with the University...

How to Develop a Value-Based Care Implementation Strategy

by Jacqueline Belliveau

When building a value-based care strategy, healthcare organizations should focus on improving care delivery across skilled nursing facilities, at-home services, and end-of-life services, Steven Strongwater, MD, President and CEO of Atrius Health,...

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