Value-based Reimbursement

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

by Jacqueline LaPointe

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,...

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

by Jacqueline LaPointe

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...

Practices Push for Quicker Value-Based Purchasing Transition

by Jacqueline LaPointe

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...

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

by Jacqueline LaPointe

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...

3 Strategies to Decrease Low-Value Care, Healthcare Costs

by Jacqueline LaPointe

Low-value care, or care for which the potential harm outweighs the possible benefits or there are little to no benefits, is unnecessarily driving up already high healthcare costs and putting providers...

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

by Jacqueline LaPointe

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...

MD All-Payer Alternative Payment Model Met Medicare Spending Goal

by Jacqueline LaPointe

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...

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

by Jacqueline LaPointe

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...

MIPS Will Impede Value-Based Purchasing Transition, MedPAC Argues

by Jacqueline LaPointe

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...

Fewer Hospitalizations Reduced Skilled Nursing Facility Use by 15%

by Jacqueline LaPointe

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...

Hospital Readmissions With Value-Based Penalties Vary by Provider

by Jacqueline LaPointe

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...

AMA, Anthem Team Up to Streamline Prior Authorizations

by Jacqueline LaPointe

The American Medical Association (AMA) and Anthem, Inc. recently announced that they will work together over the next year to streamline prior authorization requirements and improve the healthcare...

Accelerating the Value-Based Payment Transition Top HHS Priority

by Jacqueline LaPointe

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’...

72% of Medical Groups Oppose Mandatory Alternative Payment Models

by Jacqueline LaPointe

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...

Value-Based Purchasing Top Health Reform Priority for Governors

by Jacqueline LaPointe

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...

Slow and Steady Still the Motto for Value-Based Reimbursement

by Jacqueline LaPointe

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...

Hospital Execs, Payers Face Similar Value-Based Purchasing Barriers

by Jacqueline LaPointe

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...

Hospital Cost-Shifting Increases Private Payer Payments by 1.6%

by Jacqueline LaPointe

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...

Doctors to HHS: Level the Playing Field for Independent Practices

by Jacqueline LaPointe

In the face of increased hospital consolidation, HHS should better support independent practices and develop policies that allow solo providers to compete with hospitals and health systems, the...

Doctors, Employers Disagree on Healthcare Payment Reform Strategy

by Jacqueline LaPointe

Healthcare providers and employers are moving to value-based reimbursement models to achieve the Triple Aim, but the stakeholders disagree on how to move healthcare payment reform efforts forward and...