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

Value Based Reimbursement

Putting Both Feet in the Value-Based Care, Reimbursement Boat

October 23, 2018 - “Do not put each foot in a different boat,” warned Partners HealthCare CFO Peter Markell at Xtelligent Healthcare Media’s third annual Value-Based Care Summit in Boston. But the current reality in healthcare is that providers are doing just that. Healthcare organizations are operating in both the traditional fee-for-service and value-based reimbursement worlds even...


More Articles

Healthcare Dollars Moving to Alternative Payment Models, LAN Finds

by Jacqueline LaPointe

Approximately 34 percent of all healthcare payments made in 2017 were tied to an alternative payment model (APM) with shared savings, shared risk, bundled payments, or population-based payments, according to a new report from the Health...

Medical Spending, Utilization the Same for Cancer Patients in ACOs

by Jacqueline LaPointe

Cancer patients treated by providers in a Medicare accountable care organization (ACO) did not see lower medical spending or healthcare utilization compared to similar patients treated at non-ACO practices, a new study in the Journal of...

Maximizing MIPS Scores Through Chronic Disease Prevention

by Jacqueline LaPointe

The healthcare industry is moving beyond a “sick care” system and shifting to chronic disease prevention to lower costs and improve quality. However, the healthcare payment system is just catching up to the preventative care...

Hospital Readmission Program Penalties Didn’t Raise Mortality Rates

by Jessica Kent

The Hospital Readmission Reduction Program (HRRP) achieved a significant drop in readmission rates for Medicare patients hospitalized for pneumonia, acute myocardial infarction (AMI), and heart failure without bringing an increase of...

61% of Doctors Say Value-Based Care Will Damage Their Practice

by Jacqueline LaPointe

Physicians are still on the fence about the impact value-based care will have on their business and patient care, a recent survey showed. Forty-nine percent of over 3,400 physicians recently surveyed by the nation’s largest...

Medicare Bundled Payments Model Cut Costs, Maintained Quality

by Jacqueline LaPointe

Payments declined for approximately three-quarters of the clinical episode combinations in the Medicare Bundled Payments for Care Improvement (BPCI) model without impacting care quality, CMS recently reported. Of the 67 BPCI model,...

Aligning Incentives for Providers, Payers Improves Primary Care

by Jacqueline LaPointe

How the healthcare industry delivers and pays for primary care is changing as the country finds their healthcare spending skyrocketing. Healthcare spending across the country is slated to increase at an average annual rate of 5.5 percent...

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...

CMS Initiative to Create Pediatric APMs to Address Opioid Crisis

by Jacqueline LaPointe

A new CMS Innovation Center initiative will call on local stakeholders and Medicaid agencies to develop alternative payment models that address the impact of the opioid crisis for children, CMS recently announced. Medicaid and local...

Value-Based Experience, Robust EHR Use Key Factors to ACO Success

by Jacqueline LaPointe

A collaborative culture, prior value-based reimbursement experience, and robust EHR use are among the top factors contributing to accountable care organization (ACO) success, according to a new report from the Patient-Centered Primary Care...

After a Slow 2017, ACOs Grow and Expand Their Contracts in 2018

by Jacqueline LaPointe

The number of accountable care organizations (ACOs) continued to grow in 2018, as did the number of contracts the organizations entered, a new report from Leavitt Partners and the Accountable Care Learning Collaborative uncovered. From...

Academic Medical Centers Receive More Value-Based Penalties

by Jacqueline LaPointe

Academic medical centers (AMCs) are key members of the healthcare industry, engaging in medical research, uncovering clinical breakthroughs, and training future providers. However, a new analysis by Navigant shows that the organizations...

Employers Play Bigger Role in Value-Based Reimbursement Transition

by Jacqueline LaPointe

Providers wanting to expand their value-based reimbursement contracts may want to look to the employer-sponsored health plan market, according to a new report from the Duke-Margolis Center for Health Policy and the Robert Wood Johnson...

Post-Acute Care Providers Worry About Patient-Driven Payment Model

by Jacqueline LaPointe

Leading post-acute care associations are expressing concerns with the recently finalized Patient-Driven Payment Model (PDPM), which will tie skilled nursing facility (SNF) reimbursement to value, rather than therapy volume. CMS issued the...

CMS Moves Medicare Payments for Skilled Nursing Facilities to Value

by Jacqueline LaPointe

CMS recently finalized a rule that will shift the Medicare payment system for skilled nursing facilities (SNF) away from fee-for-service and toward value starting in 2019. The federal agency will make the move by implementing the...

Docs, Payer Execs Agree Providers Lack Tools for Value-Based Care

by Jacqueline LaPointe

A lack of technology and patient data may be stalling or even reversing the value-based care transition, a new survey of primary care physicians and health plan executives revealed. “Stalled Progress on the Path to Value-Based...

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...