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

Value Based Purchasing

Bundled Payment Models Here to Stay Despite CMS Program Delays

March 30, 2017 - CMS may have issued three-month delays for several new healthcare bundled payment models, but providers should still anticipate the shift to value-based purchasing through the episodic alternative payment model, said Colin Luke, a partner at Waller Lansden Dortch and Davis. “It’s a frustrating time because providers are having to tread water while they wait for new direction,”...


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Bundled Payment Models Here to Stay Despite CMS Program Delays

by Jacqueline Belliveau

CMS may have issued three-month delays for several new healthcare bundled payment models, but providers should still anticipate the shift to value-based purchasing through the episodic alternative payment model, said Colin Luke, a partner at...

AMGA President, CEO Donald W. Fisher, PhD, Passes at 71

by Jacqueline Belliveau

AMGA President and CEO, Donald W. Fisher, PhD, CAE, passed earlier this week after battling cancer, the healthcare industry group reported. Fisher, who was 71 years old, had led the organization since 1980. “Don leaves a professional and...

NAM Advises Leaders to Prioritize Value-Based Purchasing Reform

by Jacqueline Belliveau

In a new report, the National Academy of Medicine (NAM) named value-based purchasing as one of four action priorities for healthcare stakeholders in 2017. To implement more value-based purchasing models, NAM suggested that stakeholders focus...

Healthcare Spending Varies More by Provider Than Hospital

by Jacqueline Belliveau

A recent JAMA Internal Medicine study uncovered that healthcare spending varied more across individual providers than across hospitals. Based on Medicare data on hospitalized beneficiaries from 2011 to 2014, researchers from several Boston health...

Top 5 Ingredients of a Successful Alternative Payment Model

by Jacqueline Belliveau

Alternative payment models tie provider reimbursement to quality and cost performance. Besides their foundational function, though, each model has its own rules pertaining to financial incentive structures, quality measurements, and patient populations...

46% of Providers Unsure About Value-Based Purchasing Impact

by Jacqueline Belliveau

Value-based purchasing is not a new term for many providers, yet 46.4 percent of healthcare providers and leaders are still unsure how the shift away from fee-for-service payments will impact their revenue cycles, a recent Physicians Practice...

AMA Backs Team-Based Care Delivery, Value-Based Drug Pricing

by Jacqueline Belliveau

The American Medical Association (AMA) recently released updated organization-wide ethical guidelines that detailed how organizations can lower healthcare costs using team-based care delivery as well as how the industry can implement value-based...

Post-Acute Care Groups Oppose Value-Based Purchasing Program

by Jacqueline Belliveau

Eight healthcare industry groups recently told lawmakers that they oppose the proposed Medicare Post-Acute Care Value-Based Purchasing Program, which is scheduled to start on Oct. 1, 2019. In a letter to the House Committee on Ways and Means,...

CMS Tackles Value-Based Purchasing Pilot Program Questions

by Jacqueline DiChiara

Competition across the nation for value-based payment incentives is underway with the start of a new year. Nine states, each representing a different geographic region, have implemented the home health value based purchasing pilot program...

Medicare Home Health Agencies Face Upcoming Payment Changes

by Jacqueline DiChiara

The Medicare home health prospective payment system (HH PPS) can expect payment changes next year, confirms an announcement from the Centers for Medicare & Medicaid Services (CMS). These payment changes aim to ensure greater payment...

CMS: It’s Quality Over Quantity with Value-Based Purchasing

by Jacqueline DiChiara

The ever familiar “Show me the money!” mentality only rings true in the case of quality over quantity regarding hospital payments, implies the Centers for Medicare & Medicaid Services (CMS). The Hospital...

CMS Defines Physician Quality Reporting Improvement Efforts

by Jacqueline DiChiara

The new future of the physician quality reporting system (PQRS) is now more clearly defined with the recent release of a fact sheet from the Centers of Medicare & Medicaid Services (CMS). Transparently...

Value-Based Purchasing Model Revises Home Health Payments

by Jacqueline DiChiara

In an ongoing effort to advance the quality of economically profitable healthcare, the Centers for Medicare & Medicaid Services (CMS) looks again to the promotion of care quality. CMS’s new proposal launch, authorized through the Affordable...

What is the New Future of Value-Based Payment Programs?

by Jacqueline DiChiara

Medicare’s value-based payment programs provide physicians with purposeful information that can be intelligently acted upon to resultantly strengthen care quality. As the shift from physician reimbursement moves from...

How to Manage ACO Risk with Value-Based Purchasing Programs

by Jacqueline DiChiara

The game of Risk is more than just a generally entertaining board game about world supremacy. It is also a critical game healthcare providers, payers, and hospital executives play daily regarding their own revenue cycle management objectives....

Hospitals’ Value-Based Revenue Increasing Significantly

by Jacqueline DiChiara

As the healthcare pendulum swings in the direction of value-based care, recent data suggests it may be swinging more quickly than anticipated away from fee-for-service initiatives, according to a pair of hospital surveys from Kaufman,...

History of Value-Based, Accountable Care Models at CMS

by Jacqueline DiChiara

Improving the overall quality and efficiency of medical care via physicians’ active execution of “meaningful and actionable information” is necessary to promote reimbursement rewarding “value rather than volume,”...

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