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

Value Based Care

Value-Based Care, Price Transparency Rule Top Stories of 2018

December 10, 2018 - 2018 has kept healthcare revenue cycle management and finance leaders on their toes. The healthcare industry continued its slow, but steady transition to value-based care and purchasing all while navigating the new landscape of healthcare consumerism and consolidation. Hospitals, medical groups, and practices alike are facing a significantly different market compared to a decade, or...


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Healthcare Interoperability, Rule Reform Key to Value-Based Payment

by Jacqueline LaPointe

Healthcare interoperability is vital to the transition to value-based payments, the second in command at HHS recently stated at the Office of the National Coordinator for Health Information Technology (ONC) annual...

Clinicians Less Optimistic About Value-Based Care Than Execs

by Jacqueline LaPointe

Clinicians are more skeptical about the benefits or viability of value-based care and reimbursement compared to healthcare executives, a new survey shows. Only about one-third of clinicians (38 percent) in a recent NEJM Catalyst survey...

Investing in Primary Care Delivers Value-Based Care Results

by Jacqueline LaPointe

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...

Value-Based Reimbursement Reduces Costs 15.6%, Improves Quality

by Jacqueline LaPointe

Value-based reimbursement models are moving the needle on quality and cost, a new analysis from Humana shows. In 2017, medical costs for patients attributed to primary care practices (PCPs) in Humana’s value-based reimbursement...

Putting Both Feet in the Value-Based Care, Reimbursement Boat

by Jacqueline LaPointe

“Do not put each foot in a different boat,” warned Partners HealthCare CFO Peter Markell at Xtelligent Healthcare Media’s third annual Value-Based Care Summit in Boston. But the current reality in healthcare is that...

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...

Value-Based Purchasing, Consumerism Top Healthcare Exec Challenges

by Jacqueline LaPointe

Transitioning to value-based purchasing and responding to healthcare consumerism continue to be among the top challenges, issues, and opportunities healthcare C-suite leaders are facing in 2019, according to a new poll from the Healthcare...

Hospitals Seek Non-Acute, Supplier Partners for Value-Based Care

by Jacqueline LaPointe

Hospitals are looking to strategically expand their footprint in the non-acute care space to succeed in value-based care and alternative payment models, a new study of hospital decisionmakers found. L.E.K.’s ninth annual...

New Alternative Payment Model Tackles Holistic Addiction Recovery

by Jacqueline LaPointe

A national multi-sector alliance of healthcare industry leaders is looking to incentivize providers and payers to deliver coordinated, holistic addiction recovery services to patients through a new alternative payment model. Nearly 21...

Value-Based Experience, Robust EHR Use Key Factors to ACO Success

by Jacqueline LaPointe

A collaborative culture, prior value-based reimbursement experience, and robust EHR use are among the top factors contributing to accountable care organization (ACO) success, according to a new report from the Patient-Centered Primary Care...

Academic Medical Centers Receive More Value-Based Penalties

by Jacqueline LaPointe

Academic medical centers (AMCs) are key members of the healthcare industry, engaging in medical research, uncovering clinical breakthroughs, and training future providers. However, a new analysis by Navigant shows that the organizations...

Employers Play Bigger Role in Value-Based Reimbursement Transition

by Jacqueline LaPointe

Providers wanting to expand their value-based reimbursement contracts may want to look to the employer-sponsored health plan market, according to a new report from the Duke-Margolis Center for Health Policy and the Robert Wood Johnson...

Docs, Payer Execs Agree Providers Lack Tools for Value-Based Care

by Jacqueline LaPointe

A lack of technology and patient data may be stalling or even reversing the value-based care transition, a new survey of primary care physicians and health plan executives revealed. “Stalled Progress on the Path to Value-Based...

A Provider-Sponsored Health Plan Is A Hospital’s Natural Next Step

by Jacqueline LaPointe

Many hospitals and health systems are bypassing the ultimate opportunity to gain greater control of the outcomes and costs of their patients. That opportunity is developing their own provider-sponsored health plan, according to Geisinger...

More Execs Expect Value-Based Reimbursement to Up Profitability

by Jacqueline LaPointe

Approximately 46 percent of healthcare executives and managers expect value-based reimbursement contracts to improve their organization’s profitability, according to a recent KPMG survey. Healthcare leaders are more optimistic about...

How Addressing Social Determinants of Health Cuts Healthcare Costs

by Jacqueline LaPointe

Population health management and value-based reimbursement success hinge on reducing healthcare costs not only when a patient is in the exam room, but also when they are beyond the walls of the practice or hospital. Therefore,...

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

by Jacqueline LaPointe

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...

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...

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...

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