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

Accountable Care Organizations

Are Accountable Care Organizations Driving Patient Behavior?

by Jacqueline DiChiara

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

by Jacqueline DiChiara

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

by Jacqueline DiChiara

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...

Will a $1B Investment Resuscitate Rural Hospitals, Doctors?

by Jacqueline DiChiara

Imagine only one healthcare provider serving an entire state. Such a concept is a stunning concrete fact. Critical Access Hospitals (CAHs) depending on location, such as the smallest state of Rhode Island, may have only 10 or fewer patients...

Twelve Things to Know Now About Value-Based Reimbursement

by Jacqueline DiChiara

The healthcare industry continues to move away from fee-for-service and advance further into the realm of value-based care. But at what pace? Perhaps rather quickly. Some healthcare experts and leaders confirm an alleged hastening pace means...

Pioneer ACO Model: The Embrace of Population-Based Payments

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) has released an independent evaluation report revealing an innovative patient care payment model. This model, the Pioneer ACO Model, which stemmed from a pilot project and Affordable Care Act...

Cost Inflation of Hospital Mergers, Physician Acquisitions

by Jacqueline DiChiara

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

by Jacqueline DiChiara

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...

Declining Accountable Care Organizations Represent Expansion

by Jacqueline DiChiara

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...

Can Next Generation ACO Drive Patient Engagement?

by Jacqueline DiChiara

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...

What Considerations Do Alternative Payment Models Require?

by Jacqueline DiChiara

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

by Jacqueline DiChiara

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...

History of Value-Based, Accountable Care Models at CMS

by Jacqueline DiChiara

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

by Ryan Mcaskill

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...

AHA Reacts to Proposed Rule for Medicare Shared Savings Program

by Stephanie Reardon

CMS’s proposed changes to the Medicare Shared Savings Program would save approximately $280 million more than the median net savings in federal funds from 2016 through 2018. The Medicare Shared Savings Program (MSSP) seeks to save money...

Rural Hospitals Join Forces to Access ACO Incentives

by Ryan Mcaskill

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...

Looking Back on 50 Years of Medicare and Medicaid

by Stephanie Reardon

The Medicare and Medicaid system has evolved along with the healthcare industry. It was a warm day on July 30, 1965 in Washington, D.C. when President Lyndon B. Johnson signed the Social Security Amendments bill into law. This would establish...

The Benefits and Challenges to Medication Therapy Management

by Ryan Mcaskill

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

by Ryan Mcaskill

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...

Examining Private Payer ACO Contracts

by Ryan Mcaskill

A new study asked providers to discuss their risks and rewards experienced with private payer ACO contracts. Recently, the American Journal of Managed Care released a report that examined the ACO model that is currently be used by private insurers...

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