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

Value Based Care

Top 5 Ingredients of a Successful Accountable Care Organization

by Catherine Sampson

Because of the Affordable Care Act, the healthcare industry continues to move toward value-based care. As a result, Medicare has invested heavily in value-based reimbursement structures, such as accountable care organizations (ACOs), which...

New Primary Care Model Embraces Value-Based Reimbursement

by Jacqueline LaPointe

This week, CMS announced its largest multi-payer initiative to improve primary care and introduce new value-based reimbursement models. The Comprehensive Primary Care Plus (CPC+) model aims to help practices transition from the...

How Value-Based Care Payment Improves Patient Outcomes

by Vera Gruessner

Last month, the Centers for Medicare and Medicaid Services (CMS) released a new value-based care payment system for Medicare Part B drug prescribing protocols of physicians. Medicare Part B is a program in which decisions are reimbursed...

Value-Based Care Final Rule to Implement MACRA Sent to OMB

by Jacqueline LaPointe

The final rule for implementing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) — and its provisions for value-based care and reimbursement — is now in the hands of the Office of Management and Budget (OMB)...

What Does the Rise of Bundled Payments Mean For Providers?

by Dr. Richard Wheeler, CMO of Verisk Health

One of the attributes of a sustainable value-based healthcare delivery system is payment based on the value of services delivered, instead of the volume-based fee-for-service model. Bundled payments have been explored for several years as...

Hospital CEOs Share 3 Ways to Ensure Value-Based Care Success

by Jacqueline LaPointe

To support hospital revenue cycle management during the transition to accountable care, hospital executives are calling on their organizations to embrace the opportunities - and challenges - that come with the move towards value-based care...

Patient-Centric Strategy Key for Value-Based Care Reimbursement

by Vera Gruessner

As is common in today’s healthcare industry, the move toward value-based care reimbursement has put a greater focus on patient satisfaction and engagement. Quality of care is intrinsically tied to superior health outcomes and patient...

AHA Endorses Quality Reporting Software for Value-Based Care

by Jacqueline LaPointe

The American Hospital Association (AHA) recently announced that it has endorsed ENCOR Quality Reporting and Management Solution from Medisolv Inc. for providing services and products that help member healthcare providers improve...

Value-Based Care Reimbursement Needs Greater Customization

by Vera Gruessner

With rising healthcare spending found throughout the US, the federal government has put greater focus on value-based care reimbursement than ever before. Healthcare providers and payers are seeking ways to move beyond fee-for-service...

Value-Based Reimbursement May Not Bring Benefits for SNF Care

by Jacqueline LaPointe

CMS has released the Skilled Nursing Facility Utilization and Payment Public Use File, a dataset on the care skilled nursing facilities (SNF) provided to Medicare beneficiaries in 2013.  The data raises questions about the effect...

CMS Seeks Final Applications for Next Generation ACO Model

by Jacqueline LaPointe

The Centers for Medicare and Medicaid Services Innovation Center announced the opening of its final round of applications for Next Generation Account Care Organization (ACO) Model, which will begin on January 1, 2017. The final round of...

CMS Releases 2016 Results for Value-Based Care Program

by Jacqueline LaPointe

The Center for Medicare and Medicaid Services (CMS) released the results for calculating the 2016 Value Modifier, which will come as financial boost to some and hindrance to others. Out of the 8,395 eligible physician groups, which...

4 Healthcare Revenue Cycle Outcomes Make Headway at HIMSS16

by Vera Gruessner

With the HIMSS16 conference in Las Vegas, Nevada coming to an end, it is useful to look back and see which avenues are making an impact on the healthcare revenue cycle among providers. Both health IT solutions and new reports coming out of...

HIMSS: Providers Not Ready for Value-Based Care Reimbursement

by Vera Gruessner

In recent years, the healthcare industry and the revenue cycle of providers has had a much greater target of achieving value-based care reimbursement and moving away from fee-for-service payment systems. The Centers for Medicare &...

Federal Agencies Advance Alternative Payment Models in Medicine

by Vera Gruessner

In recent years, the federal government has positioned the healthcare industry to adopt new reimbursement tactics aimed at strengthening pay-for-performance initiatives. These regulations consist of alternative payment models such as...

Examining the Value-Based Alternative Payment Model Basics

by Jacqueline DiChiara

Alternative payment models like the accountable care organization (ACO) and the bundled payment model have been gaining popularity under the Affordable Care Act’s (ACA) mandates. Figuring out how alternative payment models will...

Why Patient-Centered Accountable Care Organizations Thrive

by Jacqueline DiChiara

The patient-centered accountable care organization (ACO) is the new future of healthcare. According to Mark Wagar, President of Heritage Medical Systems, when patients' voices are heard, they receive better quality...

Why Revenue Cycle Management Needs Electronic Data Exchange

by Jacqueline DiChiara

More focus on electronic data exchange can potentially save healthcare organizations, hospitals, and health systems $8 billion annually, according to a report from the American Hospital Association (AHA). Rising healthcare...

How Do High-Deductible Plans Affect Value-Based Care Goals?

by Jacqueline DiChiara

Value-based care outcomes are shaped by a variety of factors – but especially the ever influential high-deductible health plan (HDHP). The recent significant increase of HDHPs across the healthcare industry is apparently tied...

Medicare Advantage Value-Based Care Arrangements Up Revenue

by Jacqueline DiChiara

Healthcare providers have yet to recognize the significant yet untapped potential of Medicare Advantage value-based care arrangements to increase revenue, according to a study from Deloitte.  Health plans are apparently...

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