• Nearly 4 of 5 physicians employed by hospitals, corporations

    April 16, 2024 - Widespread consolidation in healthcare is affecting physicians, according to a new report from the Physicians Advocacy Institute (PAI) and Avalere Health. The report analyzed updated data from IQVIA OneKey database which contains physician and practice location information on hospital/health system ownership. The data showed that more than...

  • Private payers initially deny nearly 15% of medical claims

    March 25, 2024 - It may take some time to get paid for medical services, suggests a new survey of hospitals, health systems and post-acute care providers. Nearly 15 percent of medical claims submitted to private payers for reimbursement are initially denied, respondents representing over 500 organizations told Premier Inc. in the survey. An average of 3.2 percent...

  • CMS announces new ACO model focused on primary care

    March 19, 2024 - CMS will test a new accountable care organization (ACO) model that focuses on primary care providers starting next year. A recent announcement states that CMS will launch a five-year voluntary ACO model on January 1, 2025, as part of its flagship Medicare Shared Savings Program (MSSP). The model known as the ACO Primary Care Flex Model, or ACO PC...

  • VisiQuate, MedeAnalytics top revenue cycle analytics rankings

    March 18, 2024 - Many healthcare organizations use a third-party revenue cycle analytics solution in lieu of or next to their EHR system’s offering. A recent KLAS report found that leaders are most impressed by Visiquate and MedeAnalytics. EHR systems don’t always meet the needs of healthcare organizations when it comes to revenue cycle analytics, KLAS...


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Nearly 4 of 5 physicians employed by hospitals, corporations

Widespread consolidation in healthcare is affecting physicians, according to a new report from the Physicians Advocacy Institute (PAI) and Avalere Health. The report analyzed updated data from IQVIA...

AMA, NAACOS, AHIP share how to succeed in value-based care arrangements

The American Medical Association (AMA), the National Association of Accountable Care Organizations (NAACOS), and AHIP have released a playbook on value-based care best practices, highlighting the...

OIG: Improve Medicare rate-setting for clinical diagnostic lab tests

CMS’ procedures for setting Medicare rates for clinical diagnostic lab tests could improve for future public health emergencies, according to a new report from the Office of the Inspector General...

CMS proposes payment increases for IPPS hospitals and LTCHs

CMS has proposed a 2.6 percent payment rate increase for acute care hospitals paid under the inpatient prospective payment system (IPPS) in FY 2025. The payment update reflects a hospital market...

AMGA urges Congress to extend value-based care incentives, prevent pay cuts

The American Medical Group Association (AMGA) has urged congressional leaders to ensure provider stability by incentivizing value-based care, preventing additional Medicare payment cuts, and preserving...

Healthcare orgs reflect on top vendors for denials management services

When working with vendors for denials management services, healthcare organizations are satisfied with their levels of expertise, overturn rates, and denial prevention, according to a KLAS report. The...

Strategies for integrating specialty care into value-based care models

Value-based care models must address both primary and specialty care to improve patient outcomes and reduce spending. A CMS Innovation Center strategy details ongoing efforts to integrate specialty...

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