Value-based Care

AHA: Anti-Kickback Changes Too Narrow to Promote Value-Based Care

by Samantha McGrail

HHS’ Office of Inspector General (OIG) is taking steps toward “much needed reform” of Medicare fraud laws, but more can be done to remove the value-based care barriers presented by...

Value-Based Care, Hospital Chargemasters Dominated 2019 Headlines

by Jacqueline LaPointe

A lot can change in a year. From innovative technologies and value-based care to hospital mergers and acquisitions and new competitors, the healthcare industry has undergone yet another year of immense...

Providers Adopting Advanced Revenue Cycle Management Capabilities

by Jacqueline LaPointe

The nation’s most wired provider organizations are investing in revenue cycle management capabilities in order to perform more advanced tasks, like real-time identification and value-based care...

Physician Compensation Programs Move Toward Value-Based Pay

by Samantha McGrail

The prominence of value-based incentives in physician compensation programs increased by five to seven percent from 2018 to 2019 across four major specialty categories, according to a SullivanCotter...

Top Value-Based Payment Challenges for Skilled Nursing Facilities

by Samantha McGrail

As long-term and post-acute care (LTPAC) programs transition to value-based payment options, various challenges arise for skilled-nursing facilities (SNFs) and other long-term and post-acute care...

AMA Bolsters Healthcare Economics Training for Future Physicians

by Samantha McGrail

The American Medical Association (AMA) adopted a new policy calling on all medical schools and residency programs to include healthcare economics training related to the structure and financing of the...

Value-Based Payment Opens Doors for Better Opioid Use Disorder Care

by Jacqueline LaPointe

Nearly 64,000 Americans died from a drug overdose in 2016 alone, with opioid overdoses representing over 42,000 of those deaths, more than any previous year on record. It was that figure – as well as many other troubling statistics...

90% of SNFs Predict No Shift in Value-Based Payments in 2020

by Jacqueline LaPointe

Long-term and post-acute care providers cannot move forward with value-based payment implementation without the support of technology, according to a recent Black Book Research survey. The survey of...

Shortages, Increased Workloads Challenge Nursing Workforce

by Samantha McGrail

The current nursing workforce is facing growing pressures on their professional and personal lives due to increased demand for services, nursing shortages, and structural changes in the healthcare...

Partners, Patients Key to Achieving Value-Based Care Results

by Jacqueline LaPointe

For over a decade, the healthcare industry has been shifting provider reimbursement from a fee-for-service system to one based on the value of services provided to patients, and new payment models have...

36% of Payments Tied to Alternative Payment Models in 2018

by Jacqueline LaPointe

The healthcare industry is slowing phasing out fee-for-service payments for alternative payment models (APM), according to the latest APM Measurement Effort report from the Health Care Payment Learning...

More States Require Value-Based Reimbursement in Medicaid

by Samantha McGrail

The number of states with Medicaid managed care requiring value-based reimbursement as part of the public healthcare program increased from 22 out of 39 states in 2017 to 28 out of 40 states by 2019, a...

HHS Endorses Alternative Payment Model for Emergency Medicine

by Samantha McGrail

ACEP, an association representing 40,000 emergency physician members, developed and submitted the Acute Unscheduled Care Model (AUCM) to HHS’ Physician-Focused Payment Model Technical Advisory...

Breaking Down Proposed Changes to Anti-Kickback, Stark Law

by Jacqueline LaPointe

HHS recently made moves to update the Stark Law and Anti-Kickback Statute, two healthcare fraud rules created decades ago that have prevented physicians, hospitals, and other healthcare providers from...

Hospital Merger, Acquisition Activity Steady With 71 Deals So Far

by Jacqueline LaPointe

Hospital merger and acquisition activity through the third quarter of 2019 is running slightly ahead of 2018 levels, according to a new report from Kaufman Hall. The consulting firm recently reported...

Outsourcing on the Mind as Hospitals Pursue Value-Based Care

by Jacqueline LaPointe

Ninety percent of hospital leaders are considering outsourcing both clinical and non-clinical functions to achieve cost-efficiencies and succeed in value-based care models, revealed a recent Black Book...

CMS Proposes New Exceptions to Stark Law for Value-Based Care

by Jacqueline LaPointe

A rule proposed by CMS earlier today aims to modernize Medicare’s physician self-referral law, which is also known as the Stark Law, in an effort to advance value-based care. The Stark law...

25% of Total Healthcare Spending Attributed to Waste, Study Finds

by Jacqueline LaPointe

Despite initiatives to reduce spending and promote value over volume, a new study showed that the US healthcare system still wasted between $760 billion to $935 billion, representing approximately...

Provider Incentives, M&A to Accelerate Value-Based Care Adoption

by Jacqueline LaPointe

Healthcare providers and other industry leaders are still facing significant challenges with value-based care adoption, but provider incentives and market consolidation could help accelerate the...

Industry Group Ties Half of Business to Value-Based Payments

by Jacqueline LaPointe

Payer and provider members belonging to a group of leading healthcare stakeholders have increased the amount of business under value-based payments, even surpassing the 50 percent mark by the end of...