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

Value Based Purchasing

CMS OKs Maryland’s All-Payer Alternative Payment Model Expansion

May 16, 2018 - CMS greenlighted an expansion of an all-payer alternative payment model in Maryland that allows the state to set hospital reimbursement rates, the office of Governor Larry Hogan recently announced. Maryland’s unique alternative payment model, known as the Total Cost of Care All-Payer or Maryland Model, has been operating since 2014. And the state will now be able to extend the model...


More Articles

New Org Aims to Help Independent Practices with Value-Based Care

by Jacqueline Belliveau

The value-based care transition has been a thorn in the side of independent practices, but a group of leading provider organizations is aiming to better support solo practices in the current healthcare landscape through the formation of a new...

Only 4 CMMI Alternative Payment Models Met Spending, Quality Goals

by Jacqueline Belliveau

The CMS Innovation Center is on the path to reducing healthcare costs while improving care quality through alternative payment and care delivery models, a recent Government Accountability Office (GAO) report found. But only four alternative payment...

CMS Targets Value-Based Purchasing, Drug Costs to Reduce Spending

by Jacqueline Belliveau

Healthcare spending is growing at an unstainable rate, and CMS aims to curb spending through initiatives that promote value-based purchasing, reduce administrative burdens, and lower prescription drug costs, CMS Administrator Seema Verma told...

AMA Invests $27.2M in Health IT Co to Advance Value-Based Care

by Jacqueline Belliveau

The American Medical Association (AMA) recently invested another $27.2 million in Health2047 Inc., a health IT start-up in Silicon Valley that aims to tackle value-based care, physician productivity, and several other of healthcare’s biggest...

Practices Upping Healthcare C-Suite Bonuses for Value-Based Care

by Jacqueline Belliveau

Bonuses and incentive payments for healthcare C-suite executives are on the rise as medical groups and practices transition to value-based care, according to the most recent AMGA Medical Group Executive and Leadership Compensation Survey. The...

Practices Push for Quicker Value-Based Purchasing Transition

by Jacqueline Belliveau

The Council of Accountable Physician Practices (CAPP) recently urged policymakers to prioritize the value-based purchasing transition by accelerating the shift away from fee-for-service. “We recognize that much of policymakers’ and...

Orgs Not Living Up to Risk-Based Revenue Goals, C-Suite Says

by Jacqueline Belliveau

Provider organizations failed to achieve their risk-based revenue goals in 2017, according to the most recent State of Population Health survey by Numerof & Associates. The survey of healthcare C-suite executives showed that the majority...

Uniform Operational System Key to Value-Based Payments, CAQH Says

by Jacqueline Belliveau

The healthcare industry needs an “efficient, uniform operational system” to sustain value-based payment success, the Council for Affordable Quality Healthcare’s (CAQH) Committee on Operating Rules for Information Exchange (CORE)...

MD All-Payer Alternative Payment Model Met Medicare Spending Goal

by Jacqueline Belliveau

The Maryland All-Payer alternative payment model has already met and exceeded its five-year goal of reducing Medicare spending on hospitals by $330 million and the state is on its way to achieving care quality improvement goals, the state’s...

House Reps Create Caucus for Value-Based Reimbursement, Health IT

by Jacqueline Belliveau

Four House Representatives recently announced the creation of a new bipartisan group dedicated to supporting and promoting healthcare innovation through value-based reimbursement. Representatives Mike Kelly (R-PA), Ron Kind (D-WI), Markwayne...

MIPS Will Impede Value-Based Purchasing Transition, MedPAC Argues

by Jacqueline Belliveau

The Medicare Payment Advisory Commission (MedPAC) recently suggested that Congress repeal the Merit-Based Incentive Payment System (MIPS), arguing the new value-based purchasing program “impedes the movement toward high-value care.”...

Fewer Hospitalizations Reduced Skilled Nursing Facility Use by 15%

by Jacqueline Belliveau

Skilled nursing facility (SNF) utilization has declined 15 percent from 2009 to 2016, a new Avalere analysis revealed. The analysis of Medicare fee-for-service claims revealed that SNF utilization dropped from 1,808 SNF days per 1,000 Medicare...

Hospital Readmissions With Value-Based Penalties Vary by Provider

by Jacqueline Belliveau

Hospital readmission rates for conditions that carry value-based penalties under the Hospital Readmissions Reduction Program (HRRP) varied by admitting physician attending type, with geriatricians having the lowest 30-day readmissions rates for...

Accelerating the Value-Based Payment Transition Top HHS Priority

by Jacqueline Belliveau

Quickening the pace of the value-based payment transition is a major focus for HHS, the department’s new Secretary Alex Azar recently told attendees of the Federation of American Hospitals’ annual Public Policy Conference in Washington...

72% of Medical Groups Oppose Mandatory Alternative Payment Models

by Jacqueline Belliveau

The mandatory versus voluntary alternative payment model debate continues. This time medical group practices are voicing their opinions in a new MGMA Stat poll that found 72 percent of group leaders oppose required participation in Medicare alternative...

Value-Based Purchasing Top Health Reform Priority for Governors

by Jacqueline Belliveau

In a recent healthcare reform proposal, a bipartisan group of governors emphasized that value-based purchasing implementation will be the key to reducing healthcare costs while improving outcomes. “Coverage is important, and coverage reforms...

Slow and Steady Still the Motto for Value-Based Reimbursement

by Jacqueline Belliveau

The healthcare industry has boarded the train to value-based reimbursement. But recent roadblocks have provider organizations pumping the brakes with the shift away from fee-for-service, explained industry experts Doral Jacobsen, MBA, FACMPE,...

Hospital Execs, Payers Face Similar Value-Based Purchasing Barriers

by Jacqueline Belliveau

Payers and hospital finance executives agree that health IT inadequacies and insufficient physician buy-in are top barriers to value-based purchasing adoption, two recent surveys revealed. The Healthcare Financial Management Association’s...

Hospital Cost-Shifting Increases Private Payer Payments by 1.6%

by Jacqueline Belliveau

Healthcare organizations that faced Medicare reimbursement reductions under the Affordable Care Act engaged in hospital cost-shifting that resulted in 1.6 percent higher average payments from private payers, a new working paper from the National...

X

Join 30,000 of your peers and get free access to all webcasts and exclusive content

Sign up for our free newsletter:

Our privacy policy

no, thanks

Continue to site...