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

Value Based Reimbursement

Provider Orgs Seek Healthcare Costs Tools for Value-Based Care

by Jacqueline Belliveau

Provider organizations are increasingly looking to implement healthcare costs tools to better manage healthcare supply chain costs under value-based care models, a recent Black Book Market Research survey stated. The survey of 1,158 healthcare...

How Palliative Care Can Maximize Value-Based Reimbursement

by Jacqueline Belliveau

Providers can boost value-based reimbursement success by incorporating early palliative care into routine cancer care delivery, a new study in the American Journal of Managed Care indicated. Researchers at the Center to Advance Palliative Care...

HHS Sec. Burwell Shares Vision for Value-Based Care Future

by Jacqueline Belliveau

In a recent Health Affairs blog post, HHS Secretary Sylvia Mathews Burwell called for value-based care progress after the Obama administration ends through more alternative payment models, care delivery transformation, and health data access....

GAO Finds Value-Based Care Issues for Small, Rural Practices

by Jacqueline Belliveau

A recent Government Accountability Office (GAO) report found that small and rural practices faced several challenges with implementing value-based care models, such as limited financial resources, a lack of interoperable health IT, population...

Value-Based Care, Hospital Revenue Cycle Lead Top 2016 Stories

by Jacqueline Belliveau

From the final MACRA implementation rule to new value-based care initiatives, 2016 certainly did not leave healthcare providers bored at their desks. Instead, providers were busy digesting changes to reimbursement structures and researching ways...

AMGA: Value-Based Reimbursement Transition Slower Than Expected

by Jacqueline Belliveau

Fee-for-service revenue decreased by more than 20 percent as value-based reimbursement payments increased, reported the American Medical Group Association (AMGA). But the transition to value-based reimbursement may be slowing down compared to...

Slavitt Offers Value-Based Care Steps Post MACRA Implementation

by Jacqueline Belliveau

As CMS gets ready for MACRA implementation in the new year, CMS Acting Administrator Andy Slavitt urged healthcare and political leaders to carry on value-based care progress made under the Affordable Care Act. In a statement at the MACRA MIPS/APM...

AHA Calls for Value-Based Reimbursement Reform Under Trump

by Jacqueline Belliveau

In a recent letter to President-Elect Trump, the American Hospital Association (AHA) urged the upcoming administration to continue the value-based reimbursement transition by developing more effective alternative payment models, promoting telehealth,...

How Alternative Payment Models Decrease Cancer Care Costs

by Jacqueline Belliveau

As cancer care spending is expected to grow in the next four years, an oncology alternative payment model that incorporates clinical pathways and patient-centered approaches could reduce healthcare spending by 22 percent, or $9.1 million across...

How to Develop a Value-Based Care Implementation Strategy

by Jacqueline Belliveau

When building a value-based care strategy, healthcare organizations should focus on improving care delivery across skilled nursing facilities, at-home services, and end-of-life services, Steven Strongwater, MD, President and CEO of Atrius Health,...

Potential Challenges, Benefits of the Cardiac Bundled Payment

by Jacqueline Belliveau

Earlier this year, CMS proposed a cardiac bundled payment model that would reduce Medicare spending by $170 million on five years, but a new report in the Journal of the American Medical Association identified several potential drawbacks of the...

Only 23% Have Consumer-Centered Healthcare Capabilities

by Jacqueline Belliveau

While approximately two-thirds of healthcare leaders view consumer-centered healthcare as a priority, especially in light of value-based reimbursement, only 23 percent stated that their organization had the capabilities to develop consumer insights,...

Top 5 Facts About the Merit-Based Incentive Payment System

by Jacqueline Belliveau

In October, CMS released the final MACRA implementation rule that will put the Quality Payment Program into action on Jan. 1, 2017. Under the new value-based reimbursement program, the federal agency anticipates 592,000 to 642,000 Medicare providers...

CMS Grants $1.8B to MA Value-Based ACO Implementation Program

by Jacqueline Belliveau

The MassHealth program in Massachusetts will received about $1.8 billion over the next five years to implement value-based reimbursement structures in the statewide accountable care organization (ACO) component of the program, announced CMS....

Large Hospitals Fare Worse in Value-Based Reimbursement Model

by Jacqueline Belliveau

Large hospitals averaging approximately 260 staffed beds were more likely to receive a negative value-based reimbursement adjustment under a hospital-specific Medicare program in 2016, according to a recent report from Definitive Healthcare,...

CMS: Over Half in Value-Based Care Program to Earn Bonuses

by Jacqueline Belliveau

Over 1,600 hospitals in the Hospital Value-Based Purchasing Program, representing over 50 percent of total participants, will receive positive Medicare payment adjustments in 2017 for value-based care performance, CMS reported in a recent fact...

86% Say Provider Compensation Tied to Fee-for-Service, Salary

by Jacqueline Belliveau

About 86 percent of primary care physicians and specialists reported that their provider compensation was still primarily under fee-for-service or salary arrangements, representing a modest increase from 84 percent in 2014, according to a recent...

CMS Launches VT All-Payer Accountable Care Organization Model

by Jacqueline Belliveau

Starting in January 2017, Vermont will implement the first voluntary all-payer accountable care organization (ACO) model that will align ACO design across Medicare, Medicaid, and commercial payers, according to a recent CMS announcement. With...

Benefits, Challenges of Value-Based Health IT Implementation

by Jacqueline Belliveau

From EHR systems to mHealth apps, health IT has the potential to help providers achieve value-based care goals. But with hundreds of new technologies seemingly emerging each day, many providers are struggling to select the most appropriate health...

25% of Healthcare Payments Tied to Alternative Payment Models

by Jacqueline Belliveau

Only one-quarter of healthcare payments in 2016 will be connected to an alternative payment model that has population-based accountability, reported the Healthcare Payment Learning & Action Network (LAN). The survey of over 70 commercial,...

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