Specialty Care Providers

Strategies for integrating specialty care into value-based care models

April 4, 2024 - Value-based care models must address both primary and specialty care to improve patient outcomes and reduce spending. A CMS Innovation Center strategy details ongoing efforts to integrate specialty care into the healthcare system. Past studies have shown that Medicare beneficiaries are seeing more specialists and experiencing more fragmented care....


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Most Surgeons Earned MIPS Bonus Payments in 2021, Study Finds

by Victoria Bailey

Most surgical healthcare professionals participating in the Merit-based Incentive Payment System (MIPS) earned bonus payments in 2021, with urologists seeing the highest adjustment, a study published...

CMS Boosts End-Stage Renal Disease Medicare Rates by 2.1%

by Jacqueline LaPointe

CMS recently released the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) final rule for 2024, which includes a 2.1 percent Medicare rate hike for renal dialysis services furnished to...

Gender Pay Disparities in Medicare Reimbursement Impact Neurosurgeons

by Victoria Bailey

Gender pay disparities persisted for neurosurgeons between 2013 and 2020, with women receiving 44 percent less in annual payments than men, a study published in JAMA Surgery revealed. Researchers used...

Dana-Farber, Beth Israel Team Up To Create a Cancer Hospital

by Jacqueline LaPointe

Dana Farber Cancer Institute (Dana-Farber) is cutting ties with Brigham and Women’s Hospital to build a freestanding cancer hospital with another Boston healthcare leader. The specialty provider...

Primary Care Compensation Growth Surpassed Other Specialties in 2022

by Victoria Bailey

Primary care compensation and productivity grew at faster rates than other specialties in 2022, a survey from the American Medical Group Association (AMGA) found. AMGA’s 36th annual Medical...

CMS Proposes 1.6% Payment Increase for ESRD Facilities

by Jacqueline LaPointe

CMS has released a proposed rule for the end-stage renal disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2024. The...

Key Plans for Advancing Accountable Care, Value-Based Payment

by Jacqueline LaPointe

Accountable care is getting a makeover. For over a decade, the healthcare system has been making the shift to accountable care, or “the coordinated provision of patient services by healthcare providers and facilities with the goals...

ETC Model Did Not Significantly Boost Home Dialysis Rates

by Victoria Bailey

The End-Stage Renal Disease Treatment Choice (ETC) model did not increase home dialysis rates, despite the financial incentives it provides clinicians to offer this type of care, according to a study...

CMS Delays Radiation Oncology Model With No New Start Date

by Jacqueline LaPointe

The Radiation Oncology Model has been delayed indefinitely under a final rule released by CMS on Thursday. The alternative payment and care delivery model for cancer care aims to improve quality of...

Average Dialysis Facility Could Face Steep Penalty Under ETC Model

by Jacqueline LaPointe

Dialysis facilities required to participate in Medicare’s End-Stage Renal Disease Treatment Choices (ETC) model had a lower prevalence of transplantation waitlisting, living donor...

Specialty-Oriented ACO Improved Outcomes, Spending for ESRD Patients

by Victoria Bailey

The Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model reduced Medicare payments and hospitalizations among beneficiaries with ESRD, suggesting that specialty-oriented accountable care...

Psychiatrists See Low Merit-Based Incentive Payment System Scores

by Victoria Bailey

Psychiatrists had significantly lower performance scores, received more penalties, and earned fewer bonuses in the 2020 Medicare Merit-Based Incentive Payment System (MIPS) compared to other outpatient...

AHA Urges Congress to Address Behavioral Healthcare Provider Shortage

by Victoria Bailey

The American Hospital Association (AHA) has asked Congress to lift the caps on physician residency positions and increase financial support programs to help health systems address the shortage of...

CMS Proposes New Value-Based Payment for End-Stage Renal Disease

by Jacqueline LaPointe

CMS has issued a proposed rule that would create a new value-based payment pathway for end-stage renal disease (ESRD) facilities, as well as update Medicare rates for renal dialysis services next...

AAMC Predicts 37K to 124K Physician Shortage by 2034

by Jacqueline LaPointe

The US could see a physician shortage of 37,800 to 124,000 doctors by 2034, including shortfalls in both primary and specialty care, according to the latest numbers from the Association of American...

Automating Patient Financial Clearance Cuts Denials, Boosts Payments

by Jacqueline LaPointe

Patient financial clearance is meant to provide a seamless patient experience while ensuring a smooth revenue cycle for providers. But more often than not, the process can be drawn out, burdensome, and...