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

Value Based Care

CMS Considers Stark Law Changes to Support Value-Based Care, APMs

June 22, 2018 - CMS is seeking input on how to potentially modify the physician self-referral law, otherwise known as the Stark Law, to encourage value-based reimbursement and care delivery. In a new Request for Information (RFI), the federal agency is calling on stakeholders to describe how the Stark Law hinders care coordination and, therefore, participation in alternative payment and care delivery models....


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Value-Based Care Reduces Costs by 5.6%, Improves Care Quality

by Jacqueline LaPointe

Value-based care strategies are starting to achieve the goals of the Triple Aim, payers reported in a new ORC International study commissioned by Change Healthcare. The analysis of 120 payers across a range of organization size and type revealed...

Value-Based Care Driving Independent Practices to Consultants

by Kyle Murphy, PhD

Independent physicians and practices are turning to consultants to make the transition to value-based care and stay competitive in a shifting market. The latest research from Black Book shows physician-led practices have turned the tide that...

New Org Aims to Help Independent Practices with Value-Based Care

by Jacqueline LaPointe

The value-based care transition has been a thorn in the side of independent practices, but a group of leading provider organizations is aiming to better support solo practices in the current healthcare landscape through the formation of a new...

Only 4 CMMI Alternative Payment Models Met Spending, Quality Goals

by Jacqueline LaPointe

The CMS Innovation Center is on the path to reducing healthcare costs while improving care quality through alternative payment and care delivery models, a recent Government Accountability Office (GAO) report found. But only four alternative payment...

AMA Invests $27.2M in Health IT Co to Advance Value-Based Care

by Jacqueline LaPointe

The American Medical Association (AMA) recently invested another $27.2 million in Health2047 Inc., a health IT start-up in Silicon Valley that aims to tackle value-based care, physician productivity, and several other of healthcare’s biggest...

Practices Upping Healthcare C-Suite Bonuses for Value-Based Care

by Jacqueline LaPointe

Bonuses and incentive payments for healthcare C-suite executives are on the rise as medical groups and practices transition to value-based care, according to the most recent AMGA Medical Group Executive and Leadership Compensation Survey. The...

Practices Push for Quicker Value-Based Purchasing Transition

by Jacqueline LaPointe

The Council of Accountable Physician Practices (CAPP) recently urged policymakers to prioritize the value-based purchasing transition by accelerating the shift away from fee-for-service. “We recognize that much of policymakers’ and...

3 Strategies to Decrease Low-Value Care, Healthcare Costs

by Jacqueline LaPointe

Low-value care, or care for which the potential harm outweighs the possible benefits or there are little to no benefits, is unnecessarily driving up already high healthcare costs and putting providers at risk under value-based reimbursement models....

House Reps Create Caucus for Value-Based Reimbursement, Health IT

by Jacqueline LaPointe

Four House Representatives recently announced the creation of a new bipartisan group dedicated to supporting and promoting healthcare innovation through value-based reimbursement. Representatives Mike Kelly (R-PA), Ron Kind (D-WI), Markwayne...

MIPS Will Impede Value-Based Purchasing Transition, MedPAC Argues

by Jacqueline LaPointe

The Medicare Payment Advisory Commission (MedPAC) recently suggested that Congress repeal the Merit-Based Incentive Payment System (MIPS), arguing the new value-based purchasing program “impedes the movement toward high-value care.”...

AMA, Anthem Team Up to Streamline Prior Authorizations

by Jacqueline LaPointe

The American Medical Association (AMA) and Anthem, Inc. recently announced that they will work together over the next year to streamline prior authorization requirements and improve the healthcare experience overall through provider and payer...

Accelerating the Value-Based Payment Transition Top HHS Priority

by Jacqueline LaPointe

Quickening the pace of the value-based payment transition is a major focus for HHS, the department’s new Secretary Alex Azar recently told attendees of the Federation of American Hospitals’ annual Public Policy Conference in Washington...

Value-Based Purchasing Top Health Reform Priority for Governors

by Jacqueline LaPointe

In a recent healthcare reform proposal, a bipartisan group of governors emphasized that value-based purchasing implementation will be the key to reducing healthcare costs while improving outcomes. “Coverage is important, and coverage reforms...

Slow and Steady Still the Motto for Value-Based Reimbursement

by Jacqueline LaPointe

The healthcare industry has boarded the train to value-based reimbursement. But recent roadblocks have provider organizations pumping the brakes with the shift away from fee-for-service, explained industry experts Doral Jacobsen, MBA, FACMPE,...

Hospital Execs, Payers Face Similar Value-Based Purchasing Barriers

by Jacqueline LaPointe

Payers and hospital finance executives agree that health IT inadequacies and insufficient physician buy-in are top barriers to value-based purchasing adoption, two recent surveys revealed. The Healthcare Financial Management Association’s...

Healthcare Supply Chain Management Market to Reach $2.3B by 2022

by Jacqueline LaPointe

Growing at a compound annual growth rate (CAGR) of 8.4 percent, researchers projected the global healthcare supply chain management market to reach $2.31 billion by 2022, a recent Markets and Markets report showed. The value of the healthcare...

Reducing Low-Value Care Key to Value-Based Reimbursement Success

by Jacqueline LaPointe

Value-based reimbursement success hinges on decreasing low-value care across patient populations, explained Scott Weingarten, MD, MPH, Senior Vice President and Chief Clinical Transformation Officer at Cedars-Sinai Medical Center. While hospitals...

AMGA: Link Spending, Quality Performance for True Value-Based Care

by Jacqueline LaPointe

In response to a Request for Information from the Assistant Secretary for Planning and Evaluation (ASPE), AMGA recently called on CMS to “define value in a meaningful way” to ensure value-based care models incentivize providers to...

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

by Jacqueline LaPointe

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...

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