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

Value-Based Care News

How a Cultural Transformation Can Advance Patient Safety

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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

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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

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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

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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?

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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

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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

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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

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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

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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...

CMS: Medicare ACOs Boost Care Quality, Yield Shared Savings

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Medicare Accountable Care Organizations (ACOs) – collaborative groups of physicians, hospitals, and other healthcare providers who voluntarily unite to help provide better coordinated care – are collectively advancing Medicare beneficiaries’...

Are BHI and CCM Cost Effective Standards for Patient Care?

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Behavioral health integration (BHI) is becoming increasingly important as physical health and mental health are being viewed as equally important to a patient’s overall health. However, in addition to examining the benefits of BHI, it might...

Survey Highlights Changing Primary Care Practice Environment

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Primary care providers confirm mixed opinions regarding healthcare changes to healthcare delivery and payment within the primary care practice environment, states a new survey from the Commonwealth Fund and The Kaiser Family Foundation. Although...

Accountable Care NY Agreement Expands Value-Based Healthcare

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A notable Accountable Care arrangement and collaboration was announced yesterday between North Shore-LIJ Health System and Empire BlueCross BlueShield that will provide over 33,000 commercial and Medicare Advantage members in New York with value-based...

ACA Support Rising to 55% as Physicians Value Quality Care

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The Affordable Care Act (ACA) may be growing in popularity amongst healthcare professionals, according to a recent survey conducted by the American Association for Physician Leadership (AALP) and Navigant Center for Healthcare Research and Policy...

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

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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...

Is Fee-for-Value Payment Reform Transition Merely a Trend?

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As the pendulum swings away from the realm of fee-for-service and into the sphere of fee-for-value, the healthcare industry enters a transitional state where the status quo is becoming merely old news. Those hospitals and physician groups that...

Cigna Rejects Anthem’s ‘Woefully Skewed’ $53.8B Proposal

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The largest ever proposed health insurance merger perhaps falls short. Anthem, Inc announced its submission this week of a highly conditional, non-binding $53.8 billion proposal, including debt, to acquire Cigna Corporation for $184 per share...

ACOs Fighting Revenue Cycle Setbacks, Says Black Book Survey

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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...

Improved ACO Participation Saves $240M, Says CMS Final Rule

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Established payment algorithms of Accountable Care Organizations (ACOs) are up for review. Following a hearty cache of recently proposed physician fee schedules and payment policies, the Centers for Medicare & Medicaid Services...

CMS Finalizes ACO Medicare Shared Savings Program Rules

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The Centers for Medicare & Medicaid Services (CMS) announces a final rule updating the Medicare Shared Savings Program. The primary objective of CMS’s actions is to promote high quality care delivery for Medicare beneficiaries...

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