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

MACRA Implementation

One-Third of Healthcare Execs Ready for MACRA Implementation

by Jacqueline LaPointe

Only 35 percent of healthcare executives said that their organization has a MACRA implementation strategy and feels prepared for the new value-based reimbursement program, according to a recent Health Catalyst and peer60 survey. The...

Stakeholders Propose 4 MACRA Physician-Focused Payment Models

by Jacqueline LaPointe

MACRA’s Quality Payment Program offers 5 percent maximum incentive payments if eligible clinicians sufficiently participate in an Advanced Alternative Payment Model (APM) from 2017 to 2022. But many specialists are still waiting for...

MACRA Implementation, Healthcare Consumerism Trends at HIMSS17

by Jacqueline LaPointe

As healthcare stakeholders are packing their bags for the upcoming HIMSS17 conference in sunny Florida, many are expecting to learn about the hottest healthcare revenue cycle management topics from the past year. From MACRA implementation...

How Radiologists Can Join an Advanced Alternative Payment Model

by Jacqueline LaPointe

Radiologists may want to look to the physician-focused payment model path in MACRA to develop specialty-specific Advanced Alternative Payment Models (APM), suggested a recent Journal of the American College of Radiology report. Harvey L....

Patient Care Navigation Program Reduces Cancer Care Costs

by Jacqueline LaPointe

Using non-physician and nurse providers as part of a patient navigation program can significantly lower healthcare costs and utilization for cancer patients while generating a return on investment, a recent JAMA Oncology study...

CMS: Innovation Center Key to APM, MACRA Implementation Success

by Jacqueline LaPointe

In a recent official blog post, CMS Acting Principal Deputy Administrator Patrick Conway, MD, highlighted the federal agency’s Innovation Center’s successes with alternative payment model development, especially as MACRA...

OIG: Provider Support, Health IT Needed for MACRA Implementation

by Jacqueline LaPointe

MACRA implementation has been a major priority for CMS in the past year, but the Department of Health and Human Service’s Office of the Inspector General (OIG) recently found several challenges that could impede Quality Payment...

URAC Calls for Virtual Group Rules in Quality Payment Program

by Jacqueline LaPointe

URAC, a non-profit healthcare accreditation company, recently called on CMS to implement virtual group standards under the Quality Payment Program in 2018 that promote economies of scale for more activities than just reporting...

CMS Unveils New Medicare APMs for Quality Payment Program

by Jacqueline LaPointe

CMS finalized several new Medicare alternative payment models that will qualify for a five percent value-based incentive payment through the Quality Payment Program. The announcement contained bundled payment initiatives for cardiac and...

AMGA: Drop Transition, Add MSSP Track for MACRA Implementation

by Jacqueline LaPointe

With the Quality Payment Program set to launch on Jan. 1, 2017, the American Medical Group Association (AMGA) provided CMS with several MACRA implementation suggestions, including transition year elimination by 2018 and Medicare Shared...

Slavitt Offers Value-Based Care Steps Post MACRA Implementation

by Jacqueline LaPointe

As CMS gets ready for MACRA implementation in the new year, CMS Acting Administrator Andy Slavitt urged healthcare and political leaders to carry on value-based care progress made under the Affordable Care Act. In a statement at the MACRA...

CMS Announces New Advanced Alternative Payment Model Options

by Jacqueline LaPointe

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...

Industry Groups React to Final MACRA Implementation Rule

by Jacqueline LaPointe

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...

How MACRA Implementation Rules Affect Provider Profitability

by Jacqueline LaPointe

New value-based reimbursement models under the Quality Payment Program will launch on Jan. 1, 2017, leaving a couple of months for providers to educate themselves on MACRA implementation rules and prepare their practices for the...

Impact of Quality Payment Program on Medicare Reimbursement

by Jacqueline LaPointe

With the final rule on MACRA implementation finally emerging, eligible clinicians were presented with a range of Quality Payment Program participation options that would impact Medicare reimbursement payment adjustments in 2019. The...

CMS Finalizes MACRA Implementation, Quality Payment Program

by Jacqueline LaPointe

CMS released the long-awaited final rule on MACRA implementation earlier today, which stated that the new value-based reimbursement system will start on Jan. 1, 2017. The final MACRA implementation rule will replace the Sustainable Growth...

GOP Doctors Caucus Suggests MACRA Implementation Changes

by Jacqueline LaPointe

In a recent letter to CMS Acting Administrator Andy Slavitt and Director of the Office of Management and Budget Shaun Donovan, the GOP Congressional Doctors Caucus called for several MACRA implementation changes to make the...

AMA Releases New MACRA Implementation Resources for Providers

by Jacqueline LaPointe

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...

CMS Selects 2 Orgs to Provide MACRA Implementation Support

by Jacqueline LaPointe

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...

AMGA: New MACRA Flexibilities May Penalize Prepared Providers

by Jacqueline LaPointe

New MACRA flexibilities for the first performance year of the program may help some providers ease into new value-based reimbursement programs, but the American Medical Group Association (AMGA) recently argued that new attestation tracks...

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