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

Value-Based Care News

Accountable Care Organizations Need Financial Accountability

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Accountable care organizations (ACOs) necessitate the recognition of collective accountability for a distinct population’s cost and quality of care. Although they may be slowly on the rise within the healthcare industry, their successful...

12 Organizations Demand CMS Advance Next Generation ACO Care

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Leading healthcare organizations are actively demanding the Centers for Medicare & Medicaid Services (CMS) step up its Next Generation Accountable Care Organization (ACO) Model financial game. The National Partnership for Women...

Cost Inflation of Hospital Mergers, Physician Acquisitions

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In a recent letter addressed to The Wall Street Journal’s Editor from a group of healthcare leaders and experts, Rich Umbdenstock, President and CEO of the American Hospital Association (AHA), Brian Kent, MD, Robert W. Geist, MD, and Richard...

ACO Expansion: A Costly but Vital Sustainability Investment

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The number of accountable care organizations (ACOs) is on the rise, albeit a tad slowly, confirms new research from Niyum Ghandi, Partner at Oliver Wyman. There has been active ACO expansion activity with the healthcare indsutry. Ghandi’s...

Top HIMSS15 Revenue Cycle Educational Sessions

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Get ready for the largest and most important healthcare IT conference of the year -- the 2015 HIMSS Annual Conference & Exhibition. These highlighted sessions offer valuable insight into the realm of revenue cycle management. For those attendees...

Declining Accountable Care Organizations Represent Expansion

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The dawn of 2015 for the healthcare industry began with the Centers for Medicare & Medicaid Services (CMS) announcing an additional 89 provider organizations enrolling in the Medicare Shared Savings Program (MSSP) as accountable care organizations...

HHS Launches Health Care Payment Learning and Action Network

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The Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell met with President Obama to launch the Health Care Payment Learning and Action Network. An estimated 2800 payers, providers, employers, patients, states, consumer groups,...

Can Next Generation ACO Drive Patient Engagement?

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The Centers for Medicare and Medicaid Services (CMS) Innovation Center recently revealed plans for a new payment initiative – the Next Generation Accountable Care Organization (ACO) Model – which focuses on a unique accountable care...

Physician Practices Struggling with New Payment Models

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As physician practices continue to utilize new healthcare payment models to increase quality and decrease costs, they are actively struggling. The way physicians and health professionals are paid by the federal government and private payers is...

Physician Compensation Models Need Value-Based Reimbursement

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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...

CMS Announces Next Generation ACO Model Open Door Forum

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The Center for Medicare and Medicaid (CMS) Innovation Center revealed plans earlier this month for a new examination of accountable care with larger financial risk for hospitals and doctors and more choice for patients. As RevCycleIntelligence.com...

What Considerations Do Alternative Payment Models Require?

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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...

CMS Announces Next Generation ACO Model Initiative

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The Department of Health and Human Services (HHS) has announced its latest initiative for the Centers for Medicare & Medicaid Services’ Innovation Center (CMS Innovation Center), the Next Generation Accountable Care Organization (ACO) Model...

Summary of Health Insurance Marketplace Final Rule for 2016

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CMS issued a 476-page final rule to promote improving the overall Health Insurance Marketplace consumer experience by ensuring affordable and accessible coverage options. On February 20, the federal agency released the final rule, Notice of Benefit...

History of Value-Based, Accountable Care Models at CMS

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Improving the overall quality and efficiency of medical care via physicians’ active execution of “meaningful and actionable information” is necessary to promote reimbursement rewarding “value rather than volume,”...

Benefits of Forming an Accountable Care Organization

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Executives of a newly formed ACO discuss the decision to form, the reasons behind it and the benefits to come from it. At the start of 2015, a three year partnership went into effect between Health Net California and John Muir Health. The organizations...

Rural Hospitals Join Forces to Access ACO Incentives

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The National Rural Accountable Care Consortium is helping rural hospitals transform the care they provide. With the healthcare landscape in the middle of a major evolution and embracing value-based care, solutions that embrace coordinated care...

Coordinated Care Efforts Continue to Expand

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Facey Medical Group has stated a new partnership with Cigna to improve coordinated care efforts. Throughout the healthcare landscape, a number of organizations are making strides to improve coordinated care efforts within their own facilities....

The Benefits and Challenges to Medication Therapy Management

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This is part two of an interview about the impact of medication therapy management on ACOs and coordinated care. Yesterday, we posted part one of an interview with Robert Dubois, MD, PhD and National Pharmaceutical Council (NPC) Executive Vice...

How Medication Therapy Management Helps ACOs Manage Costs

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NPC has started a case study series that examined how pharmacists can impact ACOs, cost and quality of care. There are a number of different ways that organizations can try and reduce costs through the use of the Accountable Care Organization...

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