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

Value Based Reimbursement

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...

ACOs Fighting Revenue Cycle Setbacks, Says Black Book Survey

by Jacqueline DiChiara

The fastidious partnership of financial incentive and risk is a delicate balancing act the healthcare industry is now increasingly pressured to perfect. As the healthcare system expediently swings away from fee-for-service and into the realm...

Next Generation Analytics Demand Actionable Results

by Jacqueline DiChiara

The value-based reimbursement movement has a leader. That leader is the Centers for Medicare & Medicaid Services (CMS). Indeed, there has been a great deal of hustle and bustle regarding many recent initiatives from CMS,...

Value-Based Reimbursement: Humana CEO’s Payer Perspective

by Jacqueline DiChiara

In a Tuesday morning keynote speech at the Healthcare Information and Management Systems Society’s (HIMSS’) annual HIMSS15 conference and exhibition conducted this week in Chicago, Bruce D. Broussard, CEO and President of Humana,...

New WEDI Focus on Bundled Payments, Value-Based Initiatives

by Jacqueline DiChiara

The Workgroup for Electronic Data Interchange (WEDI) recently announced its Payment Models Workgroup is forming a new project team committee – the Bundled Payments Taskforce – to more closely examine bundled payments and various value-based...

SGR Repeal Requires New Focus on Quality Measurement

by Jacqueline DiChiara

In a landslide vote of 392 to 37, the House of Representatives passed legislation last week to permanently repeal the Sustainable Growth Rate (SGR) designed to limit the increase of Medicare physician payments that has proven highly problematic...

Examining a Holistic Approach to Revenue Cycle Management

by Jacqueline DiChiara

As healthcare continues to shift more of its focus on to the customer, a holistic approach to revenue cycle management requires addressing changing consumer behaviors. Providers experiencing an increasing array of reimbursement challenges seek...

Cost Management Effectively Optimizes Revenue Cycle Activity

by Jacqueline DiChiara

Effective means for managing revenue cycle activity and optimization continue to evolve amidst the upcoming effects of ICD-10 implementation, the urgent push for mainstream mobile data processing, and a vigorous demand for bundled and capitated...

Physician Compensation Models Need Value-Based Reimbursement

by Jacqueline DiChiara

As the healthcare reimbursement shifts from volume to value progresses, many practices are actively reviewing their current compensation plans in connection to accountable care and similar models. Although physician employment was once convolutely...

What Considerations Do Alternative Payment Models Require?

by Jacqueline DiChiara

As the direction of various payment models evolve, payers are focusing on a variety of focuses and objectives. Effective physician engagement may require a stronger focus on specialist engagement, especially in preparation for 2018’s transition...

Adapting the Healthcare Revenue Cycle to Changing Regulation

by Jacqueline DiChiara

Providers continue to evaluate healthcare revenue cycle and volume in relation to the Affordable Care Act (ACA). ACA’s underlying elements — Medicaid expansion and reform — are under close examination. Derek Bang, CPA, CGMA,...

How Will the Value-Based Payment Modifier Impact Quality

by Jacqueline DiChiara

The Centers for Medicare & Medicaid (CMS) posted results this week from first-year implementation of the Value-based Payment Modifier (VM), which rewards physicians who provide economical and valuable care. The Value Modifier – part...

Are Specialists Happy with Value-Based Reimbursement?

by Ryan Mcaskill

The switch to value-based reimbursement does not have every doctor excited for change. Value-based care is quickly becoming one of the hottest topics in the healthcare landscape. The idea is being pushed in several different ways. The Department...

Health Insurers Increase Use of Value-Based Reimbursement

by Ryan Mcaskill

As value-based reimbursement increases, more health insurance providers are increasing its focus. The push for value-based reimbursement strategies in the healthcare landscape has gained major steam over the last few months. The Department of...

Adoption of Value-Based Reimbursements Trends

by Stephanie Reardon

Organizations adopt value-based reimbursements to reduce readmission rates and meet quality of care goals. Quality and value-based reimbursements payment model adoption is increasing as the country aims to improve the quality of patient care...

Industry Reacts to HHS Value-Based Reimbursement Guidelines

by Ryan Mcaskill

Following the value-based reimbursement goal announcement from HHS, many industry organizations await more details. Earlier this week, Health and Human Services (HHS) Secretary Sylvia Burwell announced that the federal government has new goals...

HHS Announces Timetable, Goals for Value-Based Payments

by Ryan Mcaskill

For the first time, HHS has laid out goal and timeline expectations for the shift from fee-for-service to value-based reimbursement. The push away from the traditional fee-for-service payment approach to one that incentives the quality of care...

UnitedHealth Takes Steps to Embrace Value-Based Reimbursement

by Ryan Mcaskill

More healthcare providers and payers are embracing value-based reimbursement instead of fee-for-service. One of the biggest trends in the healthcare industry is the adoption of value-based reimbursement instead of the traditional fee-for-service...

Use of Value-Based Payments Continues to Increase Slowly

by Ryan Mcaskill

A new study found 39 percent of respondents use quality metrics in their payment platforms. Earlier last month, compensation consulting firm Sullivan, Cotter and Associates released its 2014 Physician Compensation and Productivity Survey. This...

NCQA Calls for Public Comment on Health Plan Accreditation

by Ryan Mcaskill

The NCQA has proposed changes to the HPA that will focus on measures that incentivize plans to focus on value-based strategies. The National Committee for Quality Assurance (NCQA) recently announced proposed changes  to the organization’s...


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