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

Value-Based Care News

Why Did Experienced Accountable Care Organizations Fail?


The Medicare Pioneer Accountable Care Organization (ACO) has proven it is able to manage larger performance-based financial risk levels. But some Pioneer ACOs dropped out when quality benchmarks were too hard to reach.

Value-Based Incentives Enrich Accountable Care Organizations


Pay-for-performance incentives positively sway physician behavior when it comes to value-based care advancement, according to a new JAMA Pediatrics study. Financial incentives tied to value-based reimbursement advance basic health measures,...

Do Accountable Care Organizations Save Claims Reimbursement?


Accountable care organizations (ACOs) are reportedly being penalized for high revenue cycle management performance. Healthcare providers looking to manage their claims reimbursement strategies remain focused on value-based care initiatives while...

Accountable Care Organizations Renew Hospital Reimbursement


Accountable Care Organizations (ACOs) may be a welcome hospital reimbursement innovation for the critical access community. Critical care organizations far away from the hustle and bustle of a nearby city face a different set of reimbursement...

CAPG Praises Next Generation Accountable Care Organizations


The Centers for Medicare & Medicaid Services (CMS) recently selected twenty-one healthcare organizations to participate in a newfangled Next Generation Accountable Care Organization (ACO) model. The 21 participating ACOs have formidable...

CMS, AMA Outline Evolving Healthcare Market Opportunities


The Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) discussed the evolving healthcare market yesterday at the J.P. Morgan Healthcare Conference in San Francisco, California. Their discussion was fittingly...

CMS Says 121 New Medicare ACO Participants Advance Quality


The new future of the Accountable Care Organization is here. The Centers for Medicare & Medicaid Services (CMS) has announced 121 new Medicare Accountable Care Organization (ACO) participants. Yesterday’s press release from...

Do Accountable Care Organizations Improve Patient Experience?


Accountable Care Organizations (ACOs) are designed to generate revenue by keeping patients happy. When ACOs were a tad newer, beneficiaries reportedly confirmed they were indeed satisfied with the level of care received from an ACO. But the push...

The Revenue Cycle Focused Accountable Care Organization


Are you a healthcare provider considering making the accountable care switch as a New Year’s resolution? Staying in the black for 2016 means anticipating and preparing for possible financial disaster. But where should your revenue...

4 Fresh Accountable Care Organization Growth Predictions


A new year calls for new accountable care organization (ACO) reflections. What is the new ACO future? Healthcare providers remain focused on collecting financial bonuses and achieving subsequent revenue cycle and ROI success. But numerous...

Top 6 Accountable Care Organization Questions Explained


Sometimes questions are more important than answers. Accountable care organizations (ACOs) — groups of doctors, hospitals, and healthcare providers helping provide Medicare beneficiaries with top-notch coordinated fee-for-service care –...

How a Cultural Transformation Can Advance Patient Safety


Everyone makes mistakes. But what happens when an innocent mistake sends someone to the grave? Hundreds of thousands of patients reportedly die annually because of avoidable medical errors. How many more need to die before the healthcare...

5 Ways to Measure Patient Experience and Patient Happiness


How do you best measure happiness? Perhaps with much more than a smile. Advancing the art of patient experience is a delicate task within the healthcare space that is often difficult to fully understand. Just because a patient fails to complain,...

Physicians Report 4 Factors of Value-Based Payment Success


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...

How Physician Shortages Are Transforming Healthcare’s Future


Just as Rome was not built in a day, neither is a doctor. Training a physician can take up to a decade; the Colosseum was perhaps ironically built in less time. With predictions of massive physician shortages gaining headway across the healthcare...

Do Medicare Shared Savings Program Final Waivers Boost ACOs?


Laws that restrict financial arrangements between hospitals, physicians, beneficiaries, and the like are on the immediate horizon, according to newly published regulation from the Centers for Medicare & Medicaid Services (CMS), the Office...

CMOs, CFOs Collectively Identify Value-Based Impediments


Chief medical officers (CMOs) and chief financial officers (CFOs) must effectively collaborate – both individually and mutually – to combat the healthcare industry’s profound complexity and intricacy, confirms an October report...

Health Insurance Coverage Still Low Despite ACA Policies


Health insurance coverage woes continue to affect a great number of individuals, claims the President of Physicians for a National Health Program (PNHP). According to a recent press release, Robert Zarr, MD, argues that despite the increase in...

Primary Care Providers Benefit from Large ACA Donations


The Department of Health & Human Services (HHS) has allocated $500 million in Affordable Care Act (ACA) funding to aid health centers and increase primary care services, according to a recent press release. The goal of this funding matches...

Value-Based Incentives Top Practice in Reimbursement Model


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...


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