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

Pay for Performance

Limited Quality Benefits for Early Pay-For-Performance Adopters

January 8, 2018 - 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 analysis of national Medicare claims data from 2003 to 2013 for over 1,100 hospitals showed that clinical process scores and 30-day mortality rates were...


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Key Capabilities for Value-Based Reimbursement Models

by Jacqueline Belliveau

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 not one-size-fits-all...

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

by Jacqueline Belliveau

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 socioeconomically...

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

by Jacqueline Belliveau

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 to be...

Do Pay-for-Performance Programs Improve Patient Outcomes?

by Jacqueline Belliveau

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 indicates. The literature...

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