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

Value Based Care

Risk-Based Alternative Payment Models Key to Value-Based Care

by Jacqueline Belliveau

Although the Department of Health & Human Services (HHS) recently announced that it had already tied 30 percent of Medicare payments to an alternative payment model nearly a year ahead of schedule, a recent study indicates that further value-based...

Only One-Third of Physicians Approve of Value-Based Care Models

by Jacqueline Belliveau

Value-based care models represent the future of patient care and reimbursement structures for most healthcare stakeholders, but some providers may not have such positive views on new payment and care arrangements. If a recent survey is any indication,...

How to Address Challenges of Alternative Payment Models

by Jacqueline Belliveau

As the healthcare industry moves towards value-based care, more providers are choosing alternative payment models to facilitate the transition. CAPG, a trade association of accountable physician organizations, has published a guide of alternative...

Value-Based Care Implementation Delayed for Most Hospitals

by Jacqueline Belliveau

While the federal government has announced explicit goals for implementing value-based care models in the next few years, some healthcare providers may not be ready to completely do away with traditional fee-for-service reimbursement structures....

AHA: Commercial ACO Tax Ruling Impedes Value-Based Care Models

by Jacqueline Belliveau

By stripping commercial accountable care organizations (ACOs) of their charitable tax exempt status, the IRS could be threatening the future of value-based care and care coordination, according to the American Hospital Association (AHA). In a...

Providers Prioritize Quality Care, Not Lower Healthcare Costs

by Jacqueline Belliveau

By now, many healthcare providers are partaking in some form of value-based care, which aims to foster quality care while reducing healthcare costs. To achieve this, value-based care relies on care coordination to decrease unnecessary treatments...

Value-Based Care Leads to Higher Costs for Surgical Complications

by Catherine Sampson

As a result of recent efforts to bring value-based care to the reimbursement cycle, it’s now more important for both providers and payers to gain an understanding about the link between costs and surgical complications, according to a recent...

For Truly Value-Based Care, Use Outcomes Instead of Processes

by Catherine Sampson

Value-based care is the goal of many of the nation’s healthcare reform efforts, yet basing regulatory changes and provider-facing metrics on checking off processes instead of achieving outcomes could be the wrong approach, states a new...

AMA Releases Value-Based Care, MACRA Resources for Providers

by Jacqueline Belliveau

As part of its STEPS Forward program, the American Medical Association (AMA) has released eight new educational modules to support healthcare providers with the transition to value-based care, reported AMA in an official press release. AMA has...

CMS Proposes New Quality Reporting for Skilled Nursing Facilities

by Catherine Sampson

CMS is hoping to bring more value-based care to skilled nursing facilities by issuing a proposed rule that raises the bar on quality reporting programs for these providers. As part of the Improving Medicare Post-Acute Care Transformation Act...

House Requests CMS Delay Quality, Value-Based Care Ratings

by Jacqueline Belliveau

A group of 225 members of the House of Representatives recently wrote a letter urging CMS it to delay the release of the hospital star rating system because it does not include relevant quality measures for assessing value-based care and the...

Bundled Payments Program Extended to Improve Value-Based Care

by Jacqueline Belliveau

The Centers for Medicare & Medicaid Services (CMS) recently announced that some healthcare organizations can extend their participation in the Bundled Payments for Care Improvement (BPCI) initiative, a program that aims to increase value-based...

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 turn...

New Primary Care Model Embraces Value-Based Reimbursement

by Jacqueline Belliveau

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 “one-size-fits-all,...

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 for prescribing...

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

by Jacqueline Belliveau

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) according...

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 an...

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

by Jacqueline Belliveau

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 models,...

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 satisfaction....

AHA Endorses Quality Reporting Software for Value-Based Care

by Jacqueline Belliveau

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....


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