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

Value Based Reimbursement

CMS Says Alternative Payment Models Still Have a Way to Go

by Jacqueline DiChiara

Leading healthcare experts are speaking out about whether or not the healthcare industry is making progress in regard to alternative payment models. The healthcare industry is apparently on the right track thus far. Thirty percent of all Medicare...

How Does Value-Based Reimbursement Affect Pediatric ACOs?

by Jacqueline DiChiara

Value-based reimbursement and pay-for-performance incentives are positively influencing pediatric accountable care organizations (ACOs), according to research from JAMA Pediatrics. The new future of value-based incentives is perhaps all...

Providers Face Value-Based Care’s Financial Reality, Demand

by Jacqueline DiChiara

The value-based care transition is a sizable endeavor for healthcare providers. Jumping in head first into dark payment water takes bravery, experience, and knowledge. Although healthcare leaders are often hesitant to fully commit to...

HHS, CMS Speak Out on CMS’s Innovation Center Pilot Project

by Jacqueline DiChiara

Medicare reimbursements are preparing to emerge from a fee-for-service caterpillar’s cocoon to a value-based butterfly. The newly announced Accountable Health Communities [AHC] model – a CMS Innovation Center Pilot...

Why the Value-Based Care Journey Begins with Assessment

by Jacqueline DiChiara

How to find value in the value-based care reimbursement movement is one goal the healthcare industry will likely be striving for in 2016. As Medicare, Medicaid, and commercial health plans continue to press hospitals and physicians to implement...

Considering Healthcare Providers’ Value-Based Risk Burdens

by Jacqueline DiChiara

Value-based reimbursement may not be good for revenue cycle management. Increasing levels of financial risk may be setting healthcare providers back, but to what extent and at what cost? As the payment model landscape changes, can providers...

Physicians List Top 5 Value-Based Payment Success Factors

by Jacqueline DiChiara

Physicians say lack of time is one of the leading obstacles they face regarding value-based care delivery, according to a study from the American Academy of Family Physicians (AAFP). One-third of family physicians are actively pursuing value-based...

Physicians Report 4 Factors of Value-Based Payment Success

by Jacqueline DiChiara

Are value-based payment models garnering favorable reviews or mere disdain from physicians? A new Value-Based Payment (VBP) Humana-funded study aims to answer this perhaps simultaneously simple yet heavy-handed question. Survey data...

Top 6 Trending Payment Models Demanding New Long-Term Focus

by Jacqueline DiChiara

Time is money, especially when it comes to healthcare. Paying for outcomes gained instead of mere services rendered is the new name of the healthcare game. This means the simple notion of paying for multiple physician visits, medical...

Top 4 Strategies to Achieve Affordable Value-Based Care

by Jacqueline DiChiara

Value over volume is the name of the revenue cycle game, with the reimbursement concept of “less is more” taking precedence. With the transition to value-based care underway, here are some top collected strategies for healthcare providers...

Humana Pays Physician Groups $77M for Value-Based Outcomes

by Jacqueline DiChiara

As the fee-for-service realm dissipates and the value-based reimbursement model nears its completed transition in coming years, Humana is granting sizable financial rewards for those physician groups yielding quality care outcomes....

Considering MACRA’s Effect on Future Meaningful Use Changes

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) has confirmed a 60-day period of public commentary regarding the Stage 3 Electronic Health Record (EHR) incentive program and the Medicare Access and CHIP Reauthorization Act of 2015...

How to Achieve Value Within the Value-Based Care Transition

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) is on a mission to associate 90 percent of Medicare payments to value within the next three years and Congressional passage of the Medicare Access and CHIP Reauthorization Act of 2015...

Black Book: CFOs Focused on ROI, Revenue Cycle Outsourcing

by Jacqueline DiChiara

Outsourcing may save the healthcare industry, according to Black Book’s yearly survey released today about high performing revenue cycle management (RCM) vendors, as reported by PR Newswire. With its research focusing primarily on RCM outsourcing...

Value-Based Incentives Top Practice in Reimbursement Model

by Sara Heath

Value-based incentives may be gaining momentum as integral parts of physician reimbursement models. A recent survey by Sullivan, Cotter, and Associates confirms that using quality-based incentives and quality metrics are becoming more prevalent...

Are the Cheapest Provider-Owned Health Plans More Expensive?

by Jacqueline DiChiara

The demise of the fee-for-service model may be unsuccessful in producing the most economically efficient health plans, confirms a new study from HealthPocket. Demonstrating significant findings that are simply “contrary to expectations,”...

How to Address Bundled Payment Cost Reduction Challenges

by Jacqueline DiChiara

As per the Affordable Care Act (ACA), the Centers for Medicare & Medicaid Services (CMS) will begin applying a value-based payment program under the physician fee schedule within the year in association with budget neutrality. This November,...

12 Value-Based Reimbursement Strategies to Cut Revenue Risk

by Jacqueline DiChiara

Value-based reimbursement is a hearty healthcare subject worth diving into as the shift from volume to value continues to evolve. Thirty percent of Medicare payments will be tied to alternative payment models, as per a recent announcement from...

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...

Risk-Value-Based Payment Programs a Return on Investment?

by Jacqueline DiChiara

Value-based payment readiness is apparently an area of weakness for senior financial executives, reports an executive survey from the Healthcare Financial Management Association (HFMA) and Humana. An analysis of return on investment (ROI), readiness...


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