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

Value Based Care

Do Pay-for-Performance Programs Improve Patient Outcomes?

by Jacqueline LaPointe

Value-based reimbursement models that pay for performance modestly incentivized providers to stick to clinical guidelines, but they may not be linked to better patient outcomes, a recent Annals of Internal Medicine study...

Addressing Social Risk in Medicare Value-Based Reimbursement

by Jacqueline LaPointe

Hospitals that disproportionately treat patients with social risk factors, such as low income and race, may be unfairly penalized under some Medicare value-based reimbursement programs. But the National Academies of Science, Engineering,...

Payment Reform, Value-Based Care Top 2017 Medicaid Priorities

by Jacqueline LaPointe

Delivery system and healthcare payment reform, especially through value-based care, topped the list of 2017 Medicaid priorities, according to the annual State Medicaid Operations Survey from the National Association of Medicaid Directors...

CMS Adds 2 Compare Websites to Boost Healthcare Transparency

by Jacqueline LaPointe

In effort to increase healthcare transparency, CMS recently added two new healthcare organization Compare websites and updated performance data for existing hospice care, hospital, and physician Compare websites. “At CMS, one of our...

Developing Post-Acute Networks for APM Reimbursement Success

by Jacqueline LaPointe

About 85 percent of healthcare C-suite leaders expect to expand post-acute care partnerships over the next three years, especially as their organizations aim to maximize alternative payment model reimbursement, a recent Premier report...

Provider Orgs Seek Healthcare Costs Tools for Value-Based Care

by Jacqueline LaPointe

Provider organizations are increasingly looking to implement healthcare costs tools to better manage healthcare supply chain costs under value-based care models, a recent Black Book Market Research survey stated. The survey of 1,158...

HHS Sec. Burwell Shares Vision for Value-Based Care Future

by Jacqueline LaPointe

In a recent Health Affairs blog post, HHS Secretary Sylvia Mathews Burwell called for value-based care progress after the Obama administration ends through more alternative payment models, care delivery transformation, and health data...

GAO Finds Value-Based Care Issues for Small, Rural Practices

by Jacqueline LaPointe

A recent Government Accountability Office (GAO) report found that small and rural practices faced several challenges with implementing value-based care models, such as limited financial resources, a lack of interoperable health IT,...

Value-Based Care, Hospital Revenue Cycle Lead Top 2016 Stories

by Jacqueline LaPointe

From the final MACRA implementation rule to new value-based care initiatives, 2016 certainly did not leave healthcare providers bored at their desks. Instead, providers were busy digesting changes to reimbursement structures and...

AMGA: Value-Based Reimbursement Transition Slower Than Expected

by Jacqueline LaPointe

Fee-for-service revenue decreased by more than 20 percent as value-based reimbursement payments increased, reported the American Medical Group Association (AMGA). But the transition to value-based reimbursement may be slowing down compared...

Value-Based Care, Price Transparency Drive Hospital Mergers

by Jacqueline LaPointe

Healthcare system and hospital mergers will likely increase as new value-based care models emerge, according to a recent Healthcare Financial Management Association (HFMA) report. But the rise in value-based reimbursement and price...

Slavitt Offers Value-Based Care Steps Post MACRA Implementation

by Jacqueline LaPointe

As CMS gets ready for MACRA implementation in the new year, CMS Acting Administrator Andy Slavitt urged healthcare and political leaders to carry on value-based care progress made under the Affordable Care Act. In a statement at the MACRA...

AHA Calls for Value-Based Reimbursement Reform Under Trump

by Jacqueline LaPointe

In a recent letter to President-Elect Trump, the American Hospital Association (AHA) urged the upcoming administration to continue the value-based reimbursement transition by developing more effective alternative payment models, promoting...

Using an Alternative Payment Model to Reduce Hospitalizations

by Jacqueline LaPointe

Are clinical interventions enough to alter provider behavior to align with value-based care? Or are providers more motivated to change because of financial incentives under alternative payment models? CMS recently partnered with the...

How to Develop a Value-Based Care Implementation Strategy

by Jacqueline LaPointe

When building a value-based care strategy, healthcare organizations should focus on improving care delivery across skilled nursing facilities, at-home services, and end-of-life services, Steven Strongwater, MD, President and CEO of Atrius...

PCP Awareness of Healthcare Costs Cuts Low-Value Resource Use

by Jacqueline LaPointe

Healthcare organizations can cut down on costly low-value services, such as antibiotic prescriptions for acute sinusitis or osteoporosis screenings for young patients, by educating primary care providers about healthcare costs, a recent...

CMS: Over Half in Value-Based Care Program to Earn Bonuses

by Jacqueline LaPointe

Over 1,600 hospitals in the Hospital Value-Based Purchasing Program, representing over 50 percent of total participants, will receive positive Medicare payment adjustments in 2017 for value-based care performance, CMS reported in a recent...

86% Say Provider Compensation Tied to Fee-for-Service, Salary

by Jacqueline LaPointe

About 86 percent of primary care physicians and specialists reported that their provider compensation was still primarily under fee-for-service or salary arrangements, representing a modest increase from 84 percent in 2014, according to a...

Benefits, Challenges of Value-Based Health IT Implementation

by Jacqueline LaPointe

From EHR systems to mHealth apps, health IT has the potential to help providers achieve value-based care goals. But with hundreds of new technologies seemingly emerging each day, many providers are struggling to select the most appropriate...

Primary Care Initiative Continues to Reduce Medicare Spending

by Jacqueline LaPointe

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...

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