Accountable Care News

Summary of Health Insurance Marketplace Final Rule for 2016

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CMS issued a 476-page final rule to promote improving the overall Health Insurance Marketplace consumer experience by ensuring affordable and accessible coverage options. On February 20, the federal...

History of Value-Based, Accountable Care Models at CMS

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Improving the overall quality and efficiency of medical care via physicians’ active execution of “meaningful and actionable information” is necessary to promote reimbursement rewarding...

Benefits of Forming an Accountable Care Organization

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Executives of a newly formed ACO discuss the decision to form, the reasons behind it and the benefits to come from it. At the start of 2015, a three year partnership went into effect between Health Net...

Rural Hospitals Join Forces to Access ACO Incentives

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The National Rural Accountable Care Consortium is helping rural hospitals transform the care they provide. With the healthcare landscape in the middle of a major evolution and embracing value-based...

Coordinated Care Efforts Continue to Expand

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Facey Medical Group has stated a new partnership with Cigna to improve coordinated care efforts. Throughout the healthcare landscape, a number of organizations are making strides to improve coordinated...

The Benefits and Challenges to Medication Therapy Management

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This is part two of an interview about the impact of medication therapy management on ACOs and coordinated care. Yesterday, we posted part one of an interview with Robert Dubois, MD, PhD and National...

How Medication Therapy Management Helps ACOs Manage Costs

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NPC has started a case study series that examined how pharmacists can impact ACOs, cost and quality of care. There are a number of different ways that organizations can try and reduce costs through the...

Examining Private Payer ACO Contracts

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A new study asked providers to discuss their risks and rewards experienced with private payer ACO contracts. Recently, the American Journal of Managed Care released a report that examined the ACO model...

Innovative Care Models Lower Costs, Improve Health

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A new study examined two new innovative care models that are focused on improving the Triple Aim of healthcare. Across the healthcare landscape, there are a number of providers that are trying out...

Are Healthcare Quality Measures ‘Over-Built?’

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In an open letter to CMS, MedPAC warns that the sheer number of quality measures could be creating problems. Healthcare quality measures have become a major priority in recent years for many hospitals....

Increase in Preventive Care Improves Health, Lowers Cost

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Since the Affordable Care Act was implemented, there has been an increase in preventive care visit from patients. One of the biggest pushes of the Affordable Care Act and other healthcare reform...

CMS Issues Proposed ACO Antitrust Regulations

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CMS has issued a proposed rule change that clarifies the formation of ACOs and could impact antitrust regulations. This week, the Centers for Medicare and Medicaid Services (CMS) released proposed...

BCBS Value-Based Care Program Grows in Michigan

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More healthcare facilities are opting for value-based care programs issued through health insurance providers. The use of value-based payments in healthcare is a growing trend that shows no signs of...

Use of Value-Based Payments Continues to Increase Slowly

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A new study found 39 percent of respondents use quality metrics in their payment platforms. Earlier last month, compensation consulting firm Sullivan, Cotter and Associates released its 2014 Physician...

How Too Much Choice is Increasing Nursing Home Costs

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A nursing facility building boom in Indiana will cost the state $24 million in additional Medicaid program payments. It is hard to imagine that building more nursing homes in a specific state could have...

Why is the Value-Based Care Adoption Rate Low?

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A new AJMC study examined the challenges that physicians face when it comes to creating value-based care. One of the hottest trends in 2014 has been the increased focus on value-based care platforms...

HHS Announces $665 Million in ACA Healthcare Funding

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The State Innovation Model initiative aims to help design and test new healthcare payment and service delivery model. The Department of Health and Human Services (HHS) is helping healthcare shift to...

How Revenue Cycle Management will Evolve in 2015

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With the healthcare market in flux, 2015 will follow the path that is being created by current trends and regulations. The last year has been filled with trends and regulations that have shaped the...

NCQA Calls for Public Comment on Health Plan Accreditation

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The NCQA has proposed changes to the HPA that will focus on measures that incentivize plans to focus on value-based strategies. The National Committee for Quality Assurance (NCQA) recently announced...

The Major Revenue Cycle Management Trends of 2014

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Revenue cycle trends have varied from payment platforms shifts to increased investments in IT solutions. There have been a number of developments from the last year that impacted revenue cycle...