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

Pay for Performance

72% of Clinicians See No Adjustment Under Value Modifier in 2018

January 24, 2018 - An overwhelming majority of clinicians who participated in the final year of the Value-Based Payment Modifier (Value Modifier) program will receive neutral payment adjustments in 2018, according to new CMS data. Out of over 1.1 million eligible clinicians in the Value Modifier, which was replaced by MACRA’s Merit-Based Incentive Payment System (MIPS), 746,556 clinicians, or 64.8...


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Limited Quality Benefits for Early Pay-For-Performance Adopters

by Jacqueline LaPointe

The impact of hospital pay-for-performance models, such as Medicare’s Hospital Value-Based Purchasing Program (HVBP), have been “limited and disappointing” over the past decade, researchers stated in a new BMJ study. The...

Key Capabilities for Value-Based Reimbursement Models

by Jacqueline LaPointe

Rising healthcare costs, shrinking reimbursement rates, and federal policies are driving hospitals and health systems to adopt value-based reimbursement, according to a new American Hospital Association (AHA) report. But the models are...

Pay-for-Performance Models Hurt Safety-Net Hospital Finances

by Jacqueline LaPointe

Medicare pay-for-performance models may disproportionately penalize safety-net hospitals and other organizations that serve the most vulnerable patient populations, a new study in Medical Care found. Hospitals in one of the most...

How Healthcare Reform, Value-Based Care Define High-Performance

by Jacqueline LaPointe

Whether through the Triple Aim or Institute of Medicine’s six aims, healthcare reform efforts and value-based care models intend to transform health systems and hospitals into high-performing entities. But what exactly does it mean...

Do Pay-for-Performance Programs Improve Patient Outcomes?

by Jacqueline LaPointe

Value-based reimbursement models that pay for performance modestly incentivized providers to stick to clinical guidelines, but they may not be linked to better patient outcomes, a recent Annals of Internal Medicine study...

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