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

Value-Based Care News

Key Ways to Succeed Under MACRA’s Quality Payment Program

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Do not feel overwhelmed by the upcoming Quality Payment Program, a healthcare expert at CAPG, a non-profit trade association for accountable physician organizations, advised the projected 592,000 to 642,000 eligible clinicians participating in...

FQHCs Push for Health Center Medicaid Payment Reform Models

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Federally qualified health centers (FQHCs) in five states voiced strong interest in Medicaid payment reform model participation to improve value-based care delivery and boost healthcare employment strategies, a recent Geiger Gibson RCHN Community...

Large Hospitals Fare Worse in Value-Based Reimbursement Model

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Large hospitals averaging approximately 260 staffed beds were more likely to receive a negative value-based reimbursement adjustment under a hospital-specific Medicare program in 2016, according to a recent report from Definitive Healthcare,...

CMS: Over Half in Value-Based Care Program to Earn Bonuses

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Over 1,600 hospitals in the Hospital Value-Based Purchasing Program, representing over 50 percent of total participants, will receive positive Medicare payment adjustments in 2017 for value-based care performance, CMS reported in a recent fact...

CMS Launches VT All-Payer Accountable Care Organization Model

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Starting in January 2017, Vermont will implement the first voluntary all-payer accountable care organization (ACO) model that will align ACO design across Medicare, Medicaid, and commercial payers, according to a recent CMS announcement. With...

CMS Announces New Advanced Alternative Payment Model Options

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CMS recently announced new opportunities for eligible clinicians to participate in an Advanced Alternative Payment Model (APM) under the Quality Payment Program in 2017 and 2018. The Oncology Care Model’s two-sided financial risk track...

Ensuring Success in the Transition to Value-Based Care

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Most recently, the Department of Health & Human Services issued a final rule for the Quality Payment Program as part of implementing provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. The program comprising the...

Rural Hospitals Faced Less Value-Based Reimbursement Penalties

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Rural hospitals outperformed urban hospitals in several Medicare value-based reimbursement programs in 2015, receiving fewer financial penalties, according to a recent report from the Department of Health and Human Services (HHS). Researchers...

Industry Groups React to Final MACRA Implementation Rule

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In the week that the healthcare industry has had to digest the 2,400-page final MACRA implementation rule, many industry groups have come forward to express support for the rule, especially attestation flexibilities, while others have challenged...

Primary Care Initiative Continues to Reduce Medicare Spending

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The Comprehensive Primary Care Initiative (CPC) continued to improve quality of care and reduce Medicare spending in 2015 even though the initiative has yet to generate net healthcare savings, according to an official CMS blog post. In the initiative’s...

Provider Engagement Key to Accountable Care Organization Success

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Accountable care organizations (ACOs) leaders may need to boost healthcare provider engagement to foster value-based care success, a recent study in the American Journal of Accountable Care indicates. In a case study at the Johns Hopkins Medicine...

CMS Launches Provider Engagement, Value-Based Care Initiative

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CMS recently announced a new provider engagement initiative designed to improve the clinician experience within the Medicare program, especially as value-based care models are developed under the Affordable Care Act and MACRA. As alternative...

AMA Releases New MACRA Implementation Resources for Providers

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With a final ruling on the proposed MACRA implementation rule expected to arrive in early November, the American Medical Association (AMA) recently released three new tools to help healthcare providers prepare for the value-based reimbursement...

AMGA Voices Concerns Over Cardiac Care Bundled Payments Model

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With the comment period on a proposed cardiac care bundled payments model closing earlier this week, the American Medical Group Association (AMGA) penned a letter to CMS Acting Administrator Andy Slavitt critiquing the mandatory Medicare demonstration....

CMS Selects 2 Orgs to Provide MACRA Implementation Support

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CMS will award up to $5 million to the Virginia Cardiac Service Quality Initiative and the American Psychological Association  to provide primary and specialist care providers with MACRA implementation support.  The two organizations...

Are Medicare Value-Based Penalties Fair to Safety Net Hospitals?

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Safety-net hospitals have to work harder to avoid value-based penalties than other participants in a Medicare program designed to reduce hospital readmissions, a new study in Health Affairs indicates. While safety-net hospitals have made significant...

Few Docs Familiar with MACRA, Transitioning to Value-Based Care

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Only 20 percent of physicians reported that they are very or somewhat familiar with MACRA, according to a recent survey from the Physicians Foundation and Merritt Hawkins, and the majority of respondents do not currently have a large portion...

Challenges, Successes of First-Year Shared Savings ACOs

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Participants in the Medicare Shared Savings Program (MSSP) already familiar with physician practice transformation were more likely to earn shared savings payments, which should lead the Centers for Medicare & Medicaid Services to focus on...

How Pioneer ACOs Earn Shared Savings, Improve Care Quality

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Massachusetts-based Atrius Health successfully managed several care quality improvements over the previous year and earned both the recognition of CMS and a portion of shared savings as a participant in the Pioneer ACO Model program. In August,...

Post-Acute Care Groups Oppose Value-Based Purchasing Program

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Eight healthcare industry groups recently told lawmakers that they oppose the proposed Medicare Post-Acute Care Value-Based Purchasing Program, which is scheduled to start on Oct. 1, 2019. In a letter to the House Committee on Ways and Means,...

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