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

Value Based Payments

Value-Based Reimbursement Reduces Costs 15.6%, Improves Quality

November 14, 2018 - 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 models for Medicare Advantage (MA) were 15.6 percent lower compared to Medicare fee-for-service, the insurer reported. Internally, medical costs were...


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CMS Shifting Home Health to Value-Based Payments Under New Model

by Jacqueline LaPointe

CMS recently finalized a new value-based payment system for home health agencies that would move Medicare reimbursement away from the volume of therapy delivered. Medicare will start to reimburse home health agencies under the...

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...

Patient Attribution Key Component to APMs, Value-Based Contracts

by Jacqueline LaPointe

Patient attribution is a critical component of alternative payment models (APMs) that appropriately hold providers accountable for their care performance. “Attribution methodology is at the core of constructing actuarially sound,...

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...

How Small Health Centers Can Succeed With Value-Based Payments

by Jacqueline LaPointe

Small community health centers should shift to a population-based mindset and deliver care management and coordination to succeed under value-based payment models, uncovered a new analysis from Health Center Partners of Southern California...

Flexibility, Value-Based Payment Key to Rural Hospital Success

by Jacqueline LaPointe

Health policies should provide rural hospitals with the flexibility to develop healthcare services that meet community needs and the value-based payment and funding structures to support tailored services, the Bipartisan Policy Center...

CMS Payment Reforms Mean Big Bucks for Medicare, Medicaid

by Catherine Sampson

Over the past month, CMS has announced finalized and proposed rules that would significantly impact payment policies in 2017 for managed care in Medicaid and the Children’s Health Insurance Program (CHIP) as well as Medicare hospice...

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...

How EHR Data Analytics Influences Value-Based Reimbursement

by Jacqueline DiChiara

As the transition away from traditional, fee-for-service payment models towards value-based reimbursement continues, the implementation of electronic health records (EHRs) is becoming the rule rather than the exception. The Centers for...

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...

CMS Says Alternative Payment Models Still Have a Way to Go

by Jacqueline DiChiara

Leading healthcare experts are speaking out about whether or not the healthcare industry is making progress in regard to alternative payment models. The healthcare industry is apparently on the right track thus far. Thirty percent of all...

Physicians List Top 5 Value-Based Payment Success Factors

by Jacqueline DiChiara

Physicians say lack of time is one of the leading obstacles they face regarding value-based care delivery, according to a study from the American Academy of Family Physicians (AAFP). One-third of family physicians are actively...

Physicians Report 4 Factors of Value-Based Payment Success

by Jacqueline DiChiara

Are value-based payment models garnering favorable reviews or mere disdain from physicians? A new Value-Based Payment (VBP) Humana-funded study aims to answer this perhaps simultaneously simple yet heavy-handed question. Survey...

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