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

Accountable Care

Importance of Post-Acute Alignment, Integration to Value-Based Care

November 2, 2017 - To achieve the ultimate goals of value-based care, healthcare organizations will need to assume greater responsibility over the patient’s experience across multiple care settings based on the appropriate level of acuity.   While the process to move away from the fragmentation associated with episodic, fee-for-service care will take some time, it is now requiring the...


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NAACOS Reveals 2017 Accountable Care Organization Priorities

by Jacqueline LaPointe

As part of its 2017 advocacy agenda, the National Association of Accountable Care Organizations (NAACOS) released policy recommendations for ACO improvement. The recommendations included Medicare Shared Savings Program (MSSP) changes,...

Provider Engagement Key to Accountable Care Organization Success

by Jacqueline LaPointe

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...

The Future of Accountable Care Organizations Involves Risk

by Jacqueline LaPointe

As many healthcare providers know, participating in a value-based care program, such as an accountable care organization, is about more than just tying payment to quality.  It involves shouldering financial risk as a way to motivate...

CMS Shares Open Payments Data to Boost Healthcare Transparency

by Jacqueline LaPointe

Healthcare vendors and manufacturers have spent $7.52 billion in payments and ownership and investment interests to providers and teaching hospitals in 2015, according to a press release from CMS. The agency published the payment data...

Characteristics of Successful Accountable Care Organizations

by Jacqueline LaPointe

As the number of accountable care organizations (ACO) continues to grow, many healthcare providers are all too familiar with the alternative payment model’s overarching goals of improving care quality, advancing population health,...

Value-Based Care Implementation Delayed for Most Hospitals

by Jacqueline LaPointe

While the federal government has announced explicit goals for implementing value-based care models in the next few years, some healthcare providers may not be ready to completely do away with traditional fee-for-service reimbursement...

Number of Accountable Care Organizations Continue to Rise

by Catherine Sampson

The number of accountable care organizations (ACOs) continue to increase across the county. Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced 121 new Medicare Accountable Care Organization (ACO)...

IRS: Commercial ACO Can’t Claim Charitable Tax Exemptions

by Catherine Sampson

An unnamed accountable care organization (ACO) will not be able to claim charitable tax exempt status since its role centered on facilitation instead of the provision of care, the IRS said in a determination letter this month. The ACO,...

MA Medicaid Proposes $1.5B Investment in Accountable Care

by Catherine Sampson

MassHealth, the combine management of Medicaid and Children's Health Insurance Programs by the Commonwealth, is joining the accountable care movement by proposing a major $1.5 billion overhaul of its reimbursement structures. By...

Rural Hospitals May Get Senate Help with Medicare Reimbursements

by Catherine Sampson

As the healthcare industry shifts from volume to value, hospitals are expected to provide quality care as many could also potentially face lower Medicare reimbursements. At the same time, many hospitals in rural and economically distressed...

NAACOS Comments on Accountable Care Organizations Benchmarks

by Vera Gruessner

Last month, the National Association of ACOs (NAACOS) submitted comments for the Health Care Payment Learning & Action Network (LAN) Financial Benchmarking Draft White Paper. NAACOS takes on the largest portion of accountable care...

Five Best Practices to Prepare for Value-Based Reimbursement

by Catherine Sampson

Accountable care organizations (ACO) hold the key to successfully implementing value-based care and receiving value-based reimbursement. However, delivering quality care while also preparing for value-based reimbursement is not a simple...

Top 5 Ingredients of a Successful Accountable Care Organization

by Catherine Sampson

Because of the Affordable Care Act, the healthcare industry continues to move toward value-based care. As a result, Medicare has invested heavily in value-based reimbursement structures, such as accountable care organizations (ACOs), which...

Why Primary Care Matters in Medicare Shared Savings Program

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) is moving forward with updating the rules and programs around accountable care organizations. The American Academy of Family Physicians  (AAFP) is urging for CMS to include key...

Hospital CEOs Share 3 Ways to Ensure Value-Based Care Success

by Jacqueline LaPointe

To support hospital revenue cycle management during the transition to accountable care, hospital executives are calling on their organizations to embrace the opportunities - and challenges - that come with the move towards value-based care...

Is the Medicare Shared Savings Program Cutting Costs?

by Vera Gruessner

The Medicare Shared Savings Program has not, as of yet, reduced healthcare spending for the federal government. Along with the lack of cost savings within the Medicare-sponsored program, Kaiser Health News reports that approximately 50...

Medicare Shared Savings Grows Among Burgeoning Payment Models

by Vera Gruessner

Since the healthcare industry has experienced rising costs over the years, providers and federal agencies have focused their energies on implementing new value-based payment models and healthcare delivery systems like accountable care...

Physician-Sponsored Accountable Care Organizations Succeed

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) is constantly attempting to reform and modify current programs in order to achieve the Triple Aim of Healthcare – reduced medical costs, better health outcomes, and improved...

Providers Squeezed to Integrate Care Management Solutions

by Vera Gruessner

At this year’s HIMSS conference and exhibition, Chilmark Research released the 2016 Care Management Market Trends report, which outlines how the market is leaning on healthcare providers to create care management solutions. The...

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