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

Value Based Reimbursement

PCP Patient Attribution Aids Providers in Value-Based Contracts

by Jacqueline LaPointe

Healthcare providers engaging in value-based contracts with shared savings opportunities earn financial bonuses or receive penalties based on the patients linked to them or their provider system. But which patient attribution model...

Long Wait Times Jeopardize Value-Based Purchasing Revenue

by Jacqueline LaPointe

Fee-for-service payment models promote long patient wait times, but providers may want to consider implementing strategies to reduce wait times to increase market share and revenue under value-based purchasing models, argued two Geisinger...

GAO: Hospital Value-Based Purchasing Model Rewards Low Quality

by Jacqueline LaPointe

A new Government Accountability Office (GAO) report found that CMS gave financial bonuses to hospitals participating in the Hospital Value-Based Purchasing Program despite the facilities earning composite quality scores below the...

Accountable Care Organizations Continue to Grow With 11% Boost

by Jacqueline LaPointe

The number of accountable care organizations (ACOs) increased with 92 more organizations operating since the first quarter of 2016, reaching a total of 923 ACOs nationwide by the start of 2017, a recent Health Affairs blogpost stated. The...

Payer Collaboration Key to Value-Based Reimbursement Strategy

by Jacqueline LaPointe

Value-based reimbursement arrangements come in a myriad of shapes and sizes much like provider organizations. But successful value-based contracts will align provider and payer goals for care quality and healthcare utilization as well as...

Industry Orgs Back 2018 MACRA Implementation Flexibilities

by Jacqueline LaPointe

Healthcare industry organizations largely applauded the recently-released 2018 MACRA implementation proposal from CMS. The medical organizations commended the federal agency’s continuation of the transition year into 2018 as well as...

Implementing Value-Based Healthcare Revenue Cycle Management

by Jacqueline LaPointe

To align healthcare revenue cycle with value-based reimbursement, healthcare organizations should start by breaking down clinical and financial siloes established by fee-for-service payment models, agreed presenters at Xtelligent...

Exploring Quality Measures Under Value-Based Purchasing Models

by Jacqueline LaPointe

CHICAGO – Jason Goldwater, MPA, MA, Senior Director of the National Quality Forum, recently likened the value-based purchasing transition to the evolution of music at Xtelligent Media’s Value-Based Care Summit in...

Targeting Skilled Nursing Facility, ESRD Care Saves ACO $15M

by Jacqueline LaPointe

A Medicare Shared Savings Program (MSSP) accountable care organization (ACO) realized over $15 million in healthcare savings between 2014 and 2015 by improving skilled nursing facility utilization and targeting end-stage renal disease...

Optimizing RCM During Value-Based Reimbursement Transition

by Jacqueline LaPointe

Value-based reimbursement revolutionized how providers get paid for care delivery. However, the slow push away from fee-for-service payments has challenged providers looking to optimize healthcare revenue cycle management. To advance...

AHA to IRS: Foster Hospital Participation in Commercial ACOs

by Jacqueline LaPointe

The American Hospital Association (AHA) recently called on leaders from the Department of Treasury and IRS to issue formal guidance that would permit non-profit hospitals to participate in commercial accountable care organizations (ACOs)...

Providers Lack Tools, Payer Alignment for Value-Based Purchasing

by Jacqueline LaPointe

Healthcare providers still lack the necessary tools for value-based purchasing success with only 43 percent of providers reporting that they have access to the appropriate solutions, a recent Quest Diagnostics and Inovalon survey...

Count Medicare Advantage Patients for Advanced APMs, Orgs Say

by Jacqueline LaPointe

Eligible clinicians participating in appropriate alternative payment models under a Medicare Advantage plan should qualify for Advanced Alternative Payment Model (Advanced APM) incentive payments in 2019, the AMGA and nine other healthcare...

Lab Experts Help Providers Reduce Low-Value Resource Use, Costs

by Jacqueline LaPointe

Collaboration between laboratory medicine experts and clinicians is critical to reducing unnecessary and low-value resource use for value-based purchasing success, the American Association For Clinical Chemistry (AACC) recently...

87% of Practices Not Adding Staff for MACRA Implementation

by Jacqueline LaPointe

About 87 percent of physician practices do not plan on hiring additional healthcare staff to help with MACRA implementation, a recent Physicians Practice survey showed. The survey of over 1,000 practice managers and physicians revealed...

Commitment Key to Successful Value-Based Reimbursement Adoption

by Jacqueline LaPointe

It is time for healthcare providers to move past understanding the concept and start the value-based reimbursement adoption process. Otherwise, they may face profitability decreases from operating both fee-for-service and alternative...

Data Analytics, Collaboration Critical to MACRA Implementation

by Jacqueline LaPointe

Healthcare providers need to restructure many aspects of their organization for successful MACRA implementation, including data analytics capabilities, financial risk assumption, stakeholder partnerships, and patient engagement strategies,...

Medicare Cardiac, Ortho Bundled Payments Delayed Until 2018

by Jacqueline LaPointe

CMS recently delayed the launch date of three mandatory Medicare cardiac and orthopedic bundled payment models and the Cardiac Rehabilitation Incentive Payment program from May 20, 2017, to Jan. 1, 2018. The final ruling from the federal...

Execs To Continue Value-Based Purchasing Despite Uncertainty

by Jacqueline LaPointe

Despite a possible Affordable Care Act repeal, healthcare executives still plan to stay the course with value-based purchasing implementation and healthcare cost reduction initiatives, a recent BDC Advisors survey reported. Although the...

Post-Acute Care Costs by Market Affect Bundled Payment Models

by Jacqueline LaPointe

A recent study in Medical Care found that post-acute care variations by healthcare market significantly impacted total episode costs in 30-day hip and knee replacement bundled payment models, suggesting financial strategies should focus on...

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