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

Primary Care Services

Investing in Primary Care Delivers Value-Based Care Results

November 19, 2018 - Supporting primary care will bring value-based care results, asserts Humana’s Chief Medical Officer Roy Beveridge, MD. Value-based arrangements between providers and payers have the lofty, yet admirable goals of improving care quality while lowering total costs of care to the healthcare system. The arrangements hold providers accountable for the financial and clinical outcomes of...


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NP, PA Office Visits Grow 129%, But Healthcare Costs Still Rising

by Jacqueline LaPointe

Office visits to primary care physicians dropped 18 percent from 2012 to 2016 among non-elderly adults with employer-sponsored healthcare coverage, the Health Care Cost Institute (HCCI) recently reported. “The decline in primary...

HRSA Awards $293M to Bolster the Primary Care Workforce

by Jacqueline LaPointe

The Health Resources and Services Administration (HRSA) is looking to bolster primary care by awarding $293 million to expand the primary care workforce, HHS recently announced. The healthcare industry is facing a serious physician...

Aligning Incentives for Providers, Payers Improves Primary Care

by Jacqueline LaPointe

How the healthcare industry delivers and pays for primary care is changing as the country finds their healthcare spending skyrocketing. Healthcare spending across the country is slated to increase at an average annual rate of 5.5 percent...

13% of People Live in an Area with a Primary Care Physician Shortage

by Jacqueline LaPointe

Approximately 13 percent of US residents, or 44 million individuals, live in a county with a primary care physician shortage, according to new data from UnitedHealth Group. The primary care physician shortage impacts all types of...

Providers Praise E/M Documentation Changes, Oppose Payment Plans

by Jacqueline LaPointe

Physicians and other healthcare professionals recently welcomed proposed evaluation and management (E/M) documentation changes from CMS that would reduce administrative burden and streamline Medicare billing. Specifically, the American...

Medical Specialist Demand Rises as Primary Care Searches Dip

by Jacqueline LaPointe

Demand for primary care physicians remains strong as provider organizations transition to population health management. But organizations are increasingly seeking medical specialists for healthcare employment, a new analysis...

Primary Care Physician Shortage Driving Bump in Compensation

by Jacqueline LaPointe

Primary care physician compensation increased by more than 10 percent over the past five years. But the rise in pay indicates a worsening primary care physician shortage, according to the 2018 DataDive Provider Compensation report from the...

Medicare Wellness Visit Adoption Boosts Primary Care Revenue

by Jacqueline LaPointe

Practices that performed Medicare wellness visits on at least a quarter of their patients earned greater primary care revenue, experienced more patient assignment stability, and treated patients who were slightly healthier, a new Health...

How CMS Improves Primary Care Payments Through Codes, APMs

by Jacqueline LaPointe

New medical billing codes for non-face-to-face encounters and alternative payment models are trying to change the way Medicare reimburses for primary care, according to researchers at the Urban Institute’s Health Policy Center. The...

Collaboration Key to Independent Physicians in Value-Based Care

by Kyle Murphy, PhD

At first glance, value-based care models appear to work against independent physicians. The risk-based arrangement requires a coordination of services across care continuum — primarily between primary care physicians and specialists...

Medical Billing Codes Do Not Address Full Scope of Primary Care

by Jacqueline LaPointe

Current Procedural Terminology (CPT) codes used for medical billing did not account for all the care provided by primary care physicians in about 60.3 percent of visits, a recent Journal of the American Board of Family Medicine study...

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...

Does the Medicare Physician Fee Schedule Undervalue Primary Care?

by Jacqueline LaPointe

CMS continues to put the revenue of primary care providers at risk by undervaluing codes for primary care and failing to meet the misvalued code target required by law in the proposed 2018 Medicare Physician Fee Schedule update, the...

Primary Care Job Growth Slows, Affecting Healthcare Spending

by Jacqueline LaPointe

With the number of specialist jobs rising nearly six times faster than primary care provider positions between 2005 and 2015, industry efforts to control and reduce healthcare spending may be in trouble, a recent Health Affairs blogpost...

Is a Chief Primary Care Officer Key to Value-Based Purchasing?

by Jacqueline LaPointe

Developing a Chief Primary Care Medical Officer role should help health systems achieve value-based purchasing success by focusing on establishing care coordination systems and improving key quality measures, argued industry experts in a...

Seeing PCP As Main Provider Lowered Medicare Spending by 9%

by Jacqueline LaPointe

Using a primary care provider versus a specialist as the predominant provider of care and care coordination resulted in similar clinical outcomes for Medicare beneficiaries. But Medicare spending was $1,781 lower per beneficiary, a recent...

CMS Opens Comprehensive Primary Care Plus Apps in 4 Regions

by Jacqueline LaPointe

CMS recently announced that the second round of the Comprehensive Primary Care Plus (CPC+) alternative payment model will launch in four regions in 2018. The four regions are Louisiana, Nebraska, North Dakota, and the greater Buffalo area...

Do NP, PA Ordering Habits Lead to Higher Healthcare Costs?

by Jacqueline LaPointe

Nurse practitioners and physician assistants did not contribute to higher healthcare costs by ordering more ancillary or expensive services compared to primary care providers, a recent American Journal of Managed Care study uncovered. The...

Healthcare Consumerism Challenges Primary Care Business Models

by Jacqueline LaPointe

Primary care providers are facing significant and oftentimes conflicting challenges in response to two major healthcare trends: value-based purchasing implementation and the rise of healthcare consumerism, a recent Journal of Internal...

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