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

Value-Based Care News

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...

CMS: Medicare ACOs Boost Care Quality, Yield Shared Savings


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?


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


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


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


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?


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?


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


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


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


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


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...

Healthcare Experts’ Top 5 Accountable Care Organization Tips


Accountable care organizations (ACOs) and accountable care models have existed on the forefront of the healthcare industry as an emerging and dynamic focus for healthcare providers, payers, and executives. As recent initiatives within the past...

Are Accountable Care Organizations Driving Patient Behavior?


Accountable care organizations (ACOs) are on the tip of many a healthcare executive’s tongue. There is often a comfort and ease to the idea of reflection within the healthcare industry, especially within the realm of ACO implications. Looking...

Accountable Care Organizations Need Financial Accountability


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


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...

7 Reasons to Merge Revenue Cycle and Supply Chain Management


Hospitals demand increased revenue to strengthen their bottom lines within an era of evolving healthcare reform. Comprehending the total cost of care and maximizing revenue capture projections and opportunities can be complex and cumbersome....

Cost Inflation of Hospital Mergers, Physician Acquisitions


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


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...


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