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

Primary Care Services

Seeing PCP As Main Provider Lowered Medicare Spending by 9%

June 13, 2017 - 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 Journal of the American Geriatrics Society study unveiled. Medicare spending was 9 percent less when beneficiaries saw a primary care provider as their main...


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CMS Opens Comprehensive Primary Care Plus Apps in 4 Regions

by Jacqueline Belliveau

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 of...

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

by Jacqueline Belliveau

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 analysis...

Healthcare Consumerism Challenges Primary Care Business Models

by Jacqueline Belliveau

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 Medicine...

Lean Primary Care Improves Physician Productivity, Costs

by Jacqueline Belliveau

A recent American Journal of Managed Care study showed that implementing a Lean primary care model resulted in operational cost reductions, physician productivity improvements, and higher patient satisfaction scores. “Our findings indicate...

More Primary Care Leads to Less End-of-Life Medicare Spending

by Jacqueline Belliveau

Regions with more primary care providers saw less Medicare spending on end-of-life care compared to areas with less primary care practices, a recent Annals of Family Medicine study found. Medicare spending during the last two years of life was...

AAFP: Primary Care Undervalued in Medicare Reimbursement

by Jacqueline Belliveau

CMS released updated physician fee schedule rates in November 2016, but the American Academy of Family Physicians (AAFP) recently contended that Medicare reimbursement rates for primary care providers are still lacking. In a letter to CMS, the...

How Broader Primary Care Teams Can Decrease Healthcare Costs

by Jacqueline Belliveau

Developing broader primary care teams that interact with specific patient populations can save healthcare costs and realize a return on investment, according to a recent PricewaterhouseCoopers (PwC) analysis. For example, a primary care team...

Primary Care Initiative Continues to Reduce Medicare Spending

by Jacqueline Belliveau

The Comprehensive Primary Care Initiative (CPC) continued to improve quality of care and reduce Medicare spending in 2015 even though the initiative has yet to generate net healthcare savings, according to an official CMS blog post. In the initiative’s...

AMGA Urges CMS to Release Claims Reimbursement Plan for CPC+

by Jacqueline Belliveau

The American Medical Group Association (AMGA) has called on CMS to release the claims reimbursement formula for the Comprehensive Primary Care + (CPC+) model, according to a letter sent to the federal agency earlier this week. The value-based...

HHS Awards $100M to Health Centers for Quality Improvement

by Jacqueline Belliveau

The Department of Health and Human Services recently granted over $100 million in awards to 1,304 health centers across the nation to help improve care quality and boost primary care services, according to the federal department’s website....

At-Home Service Value-Based Care Model Saves Medicare $10M

by Jacqueline Belliveau

A value-based care model designed to deliver at-home primary care services to patients who suffer from multiple chronic diseases has continued to improve beneficiary outcomes and reduce Medicare spending. Medicare saved $10 million during the...

Team-Based Primary Care Cuts FFS Healthcare Revenue by 2.5%

by Jacqueline Belliveau

As healthcare providers continue to transition to value-based care, many hospitals and physician practices have focused on how to improve care coordination and team-based approaches to improve patient outcomes and boost their healthcare revenue...

CMS Opens Enrollment for Value-Based Primary Care Model

by Jacqueline Belliveau

CMS has opened the application period for the Comprehensive Primary Care Plus (CPC+) model, a value-based reimbursement initiative for primary care physicians in 14 areas of the country. The application period will be open until September 15,...

HRSA Grants to Boost Healthcare Employment for Primary Care

by Jacqueline Belliveau

The Health Resources and Services Administration (HRSA) has announced over $149 million in awards to support healthcare employment efforts to increase the number of primary care providers, the federal agency announced. To help prepare the next...

CMS Proposes Medicare Payment Reform Rule for Primary Care

by Jacqueline Belliveau

In efforts to better support primary care physicians, CMS has announced a proposed Medicare payment reform rule that would improve payment accuracy for providers who treat chronically ill and medically complex patients. The rule would update...

CMS Allows Some ACOs to Join New Value-Based Care Model

by Jacqueline Belliveau

CMS has expanded the eligibility requirements in the Comprehensive Primary Care Plus (CPC+) model to include primary care physicians in certain Medicare accountable care organizations (ACOs), according to an updated fact sheet. Up to 1,500 primary...

Patient Scheduling Still Problematic at VA Medical Settings

by Catherine Sampson

In a perfect world, the Department of Veterans Affairs’ (VA) patient scheduling system works effectively so veterans are able to access primary care physicians easily. Unfortunately, many veterans continue to face extremely long wait times...

New Primary Care Model Embraces Value-Based Reimbursement

by Jacqueline Belliveau

This week, CMS announced its largest multi-payer initiative to improve primary care and introduce new value-based reimbursement models. The Comprehensive Primary Care Plus (CPC+) model aims to help practices transition from the “one-size-fits-all,...

Why Chronic Illness is Threatening the Healthcare Industry

by Jacqueline DiChiara

1 in 4 primary care physicians feel dangerously ill-equipped to successfully handle and coordinate care for some of their most challenging patients, such as those with chronic conditions, severe mental illness, and those in need of long-term...

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