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

Value Based Reimbursement

NAM Advises Leaders to Prioritize Value-Based Purchasing Reform

March 22, 2017 - 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 on three healthcare payment reforms: driving payment innovation by incentivizing improved outcomes and value, supporting providers as they transition...


More Articles

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...

MGMA to CMS: Notify Clinicians About MIPS Eligibility ASAP

by Jacqueline Belliveau

The Medical Group Management Association (MGMA) recently called on CMS Administrator Seema Verma to immediately release Merit-Based Incentive Payment System (MIPS) eligibility notifications as well as approved vendor lists and hospital or patient-facing...

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...

Health IT, Care Navigators Most Effective at Lowering Costs

by Jacqueline Belliveau

While countless strategies are out there for making care delivery more efficient, a recent Health Affairs study revealed that interventions that use health IT and community health workers realized the greatest cost savings. Researchers examined...

Higher Hospital Costs Stem from ICU Overuse for Some Conditions

by Jacqueline Belliveau

Healthcare providers may be able to decrease hospital costs by avoiding ICU admissions for some patients with chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), and acute myocardial infarction (AMI), a recent American...

274 Orgs Calls on CMS to Add Medicare Advantage Advanced APMs

by Jacqueline Belliveau

CMS should develop financial incentives comparable to those in the Quality Payment Program’s Advanced Alternative Payment Model (APM) track for providers who assume financial risk under Medicare Advantage plans, CAPG and 273 other healthcare...

Premier: Bundled Payment Models Should be Voluntary Nationwide

by Jacqueline Belliveau

Premier Healthcare Alliance recently offered CMS several recommendations for bundled payment model development, including making programs voluntary for providers across the nation. CMS has implemented several mandatory bundled payment models...

CMS Reopens Next Generation ACO Application Request Portal

by Jacqueline Belliveau

Providers interested in joining the Next Generation Accountable Care Organization (ACO) model in 2018 can now access the Request for Applications and Letter of Intent on the program’s portal, according to a recent CMS announcement. The...

FFS Compensation Linked to More Stroke Prevention Surgeries

by Jacqueline Belliveau

A new study in JAMA Surgery found that providers with fee-for-service compensation performed more carotid stenosis interventions on symptomatic and asymptomatic patients compared to providers reimbursed by a salary. Using data from the Military...

65% of Organized Providers Paid Via Alternative Payment Models

by Jacqueline Belliveau

Nearly two-thirds of healthcare providers in some type of integrated employment model, such as integrated health networks, physical hospital organizations, accountable care organizations, and large medical groups, are primarily reimbursed through...

AHA Critiques MedPAC’s Potential MACRA Implementation Changes

by Jacqueline Belliveau

The American Hospital Association (AHA) recently responded to potential MACRA implementation changes discussed at the Medicare Payment Advisory Commission’s (MedPAC) January meeting. The industry group called on MedPAC to “draw upon...

Exploring MIPS Advancing Care Info, Improvement Activities

by Jacqueline Belliveau

At HIMSS17, CMS leaders took the stage to ease provider concerns about the newly launched Quality Payment Program and its more popular value-based reimbursement track, the Merit-Based Incentive Payment System (MIPS). Following up on their MIPS...

CMS Calls on Stakeholders for Pediatric APM Development Input

by Jacqueline Belliveau

CMS recently put out a request for information for a potential Medicaid and Children’s Health Insurance Program (CHIP) alternative payment model targeting pediatric care, according to an official CMS blog post. “Through the RFI [request...

Transradial, Same Day Discharge Cardiac Care Drops Costs by $3.7K

by Jacqueline Belliveau

From acute myocardial infarctions to coronary artery bypass grafts initiatives, recent Medicare bundled payment models have providers focusing more on reducing healthcare costs and improving care quality for a range of cardiac care episodes....

Provider Profitability Tops Healthcare Revenue Cycle Concerns

by Jacqueline Belliveau

One of the top healthcare revenue cycle concerns with 40 percent of providers is maintaining profitability while remaining independent, a recent RemitDATA survey revealed. The survey of healthcare providers, billing companies, and vendors showed...

Creating a Population Health Management Operating Model

by Jacqueline Belliveau

ORLANDO - “Collaboration is a critical piece,” Steven Merahn, MD, emphasized during his HIMSS17 session on developing an operating model for population health management that functions regardless of payment model participation. “Collaboration...

Healthcare C-Suite, Earned Incentive Compensation Down in 2016

by Jacqueline Belliveau

Median healthcare CEO compensation in terms of total cash value remained relatively the same for non-physician executives in 2016, while physician CEOs faced a 3.9 percent reduction, a recent AMGA Consulting survey found. The survey of 78 medical...

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...

X

Join 30,000 of your peers and get free access to all webcasts and exclusive content

Sign up for our free newsletter:

Our privacy policy

no, thanks