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

Care Quality

Care Variation Reduction Key to Improving Care Quality, Costs

October 4, 2018 - Higher care quality and care variation reduction result in lower healthcare costs, according to a new Advisory Board analysis. Analyzing healthcare cost and quality data from 468 hospitals from April 2014 to March 2017, the healthcare best practices firm found that high-quality hospitals delivered lower cost care for approximately 82 percent of diagnoses. High-quality hospitals...


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Do Hospital Mergers, Acquisitions Increase Prices, Reps Ask MedPAC

by Jacqueline LaPointe

Energy and Commerce Committee leaders are calling on the Medicare Payment Advisory Commission (MedPAC) to settle the debate on whether hospital mergers and acquisitions raise prices for patients. In a recent letter to MedPAC’s...

Quality Improvement Projects Save Children’s Hospitals Millions

by Jacqueline LaPointe

Care quality improvements require hospitals to invest their money, time, and staff. The investment may be large, but for two children’s hospitals it paid off, saving the organizations millions and reducing costly accidents and...

Healthcare Mergers, Consolidation Increase Patient Safety Risks

by Jacqueline LaPointe

Healthcare mergers and acquisitions, institutional affiliations, shared service agreements, and other healthcare consolidation activities may help organizations realize economies of scale and other financial benefits. But a recent JAMA...

3 Strategies to Decrease Low-Value Care, Healthcare Costs

by Jacqueline LaPointe

Low-value care, or care for which the potential harm outweighs the possible benefits or there are little to no benefits, is unnecessarily driving up already high healthcare costs and putting providers at risk under value-based...

Reducing Low-Value Care Key to Value-Based Reimbursement Success

by Jacqueline LaPointe

Value-based reimbursement success hinges on decreasing low-value care across patient populations, explained Scott Weingarten, MD, MPH, Senior Vice President and Chief Clinical Transformation Officer at Cedars-Sinai Medical Center. While...

Six Characteristics of High-Value Primary Care Practices

by Jacqueline LaPointe

High-value primary care practices that achieved exceptional care quality at reduced costs shared six attributes centered around risk-stratified care management, mindful specialist selections, and care coordination, a new study in the...

Type of Provider Data Presented Influences Patient Volume, Choice

by Jacqueline LaPointe

Healthcare consumers who initially prioritized appointment availability when choosing a physician were four times more likely to select a physician based on provider data on quality performance and clinical expertise when presented with...

Low-Cost, Low-Value Resource Use Drives $586M in Wasteful Spending

by Jacqueline LaPointe

Inexpensive low-value resource use resulted in over $586 million, or $9.09 per beneficiary per month, in unnecessary healthcare spending in Virginia, a new Health Affairs study showed. The total amount spent on low-cost, low-value...

Driven by Fee-For-Service, Docs Say Up to 30% of Care Unnecessary

by Jacqueline LaPointe

At least 15 percent to 30 percent of medical care is unnecessary, contributing to low-value resource use and wasteful healthcare spending, stated the majority of physicians surveyed in a recent PLOS ONE study. While the survey of...

MSSP ACOs Decreased Spending by $1B, Improved Care Quality

by Jacqueline LaPointe

Accountable care organizations (ACOs) participating in the first three years of the Medicare Shared Savings Program (MSSP) reduced Medicare spending, with a net reduction of almost $1 billion, according to a new OIG report. The analysis...

Exploring Quality Measures Under Value-Based Purchasing Models

by Jacqueline LaPointe

CHICAGO – Jason Goldwater, MPA, MA, Senior Director of the National Quality Forum, recently likened the value-based purchasing transition to the evolution of music at Xtelligent Media’s Value-Based Care Summit in...

Care Standardization Key to Healthcare Revenue Cycle Excellence

by Jacqueline LaPointe

To be named a top health system by Truven Health Analytics and IBM Watson Health, it takes a range of clinical quality improvements and healthcare revenue cycle efficiencies. But for St. Luke’s Health System, one of 15 top health...

AMGA: Align Medicare Reimbursement, Measures for High-Value Care

by Jacqueline LaPointe

AMGA recently called on CMS to align quality measures with spending performance as well as Medicare reimbursement policies across Medicare Advantage, fee-for-service models, and accountable care organizations (ACOs). In two letters to CMS...

How Do Hospital Mergers Lower Costs, Drive Quality Improvement?

by Jacqueline LaPointe

Recent hospital mergers and acquisitions led to significant healthcare costs savings without sacrificing care quality and affordable prices, a recent Charles River Associates and American Hospital Association (AHA) report indicated. Based...

AHA Seeks Changes to Post-Acute Care Medicare Reimbursement

by Jacqueline LaPointe

The American Hospital Association (AHA) has called on the Centers of Medicare and Medicaid Services (CMS) to revise proposed Medicare reimbursement reforms for two post-acute care models. In separate letters, the AHA outlined several...

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