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

Value-Based Care News

Do Proposed Quality Payment Program Changes Support Specialists?

August 16, 2018 - The American Society of Clinical Oncology (ASCO) recently expressed their concerns with proposed Quality Payment Program changes, arguing the potential implementation policies for the third year of the program do not align with specialty care. “The recently released 2019 Quality Payment Program (QPP) rule in combination with the Medicare Physician Fee Schedule (MPFS) raises...


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


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


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


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...

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


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...

EHR Costs, Staffing Still Trouble Small, Rural Practices in MIPS


Financial challenges plaguing small and rural practices under legacy Medicare value-based purchasing programs are likely to persistent under the Merit-Based Incentive Payment System (MIPS), the Government Accountability Office (GAO)...

More Execs Expect Value-Based Reimbursement to Up Profitability


Approximately 46 percent of healthcare executives and managers expect value-based reimbursement contracts to improve their organization’s profitability, according to a recent KPMG survey. Healthcare leaders are more optimistic about...

ACOs and Other Value-Based Purchasing Models Have Yet to Cut Costs


Accountable care organizations (ACOs) and other population-based value-based purchasing models have not decreased total cost of care or generated quality improvements at the market level, a new study found. The Healthcare Financial...

How Addressing Social Determinants of Health Cuts Healthcare Costs


Population health management and value-based reimbursement success hingeĀ on reducing healthcare costs not only when a patient is in the exam room, but also when they are beyond the walls of the practice or hospital. Therefore,...

Value-Based Care Reduces Costs by 5.6%, Improves Care Quality


Value-based care strategies are starting to achieve the goals of the Triple Aim, payers reported in a new ORC International study commissioned by Change Healthcare. The analysis of 120 payers across a range of organization size and type...

How Small Health Centers Can Succeed With Value-Based Payments


Small community health centers should shift to a population-based mindset and deliver care management and coordination to succeed under value-based payment models, uncovered a new analysis from Health Center Partners of Southern California...

HHS Bringing Value-Based Purchasing to SNFs, Post-Acute Care


HHS Secretary Alex Azar identified value-based purchasing as the key to reducing hospital readmissions and moving skilled nursing facilities and other post-acute care providers to coordinated community care. In a speech to the American...

Hospitalization-Based Bundled Payment Models Key to Lowering Costs


Bundled payment models should center on acute hospitalizations, rather than outpatient care, because hospitalization-based bundles can more effectively impact post-acute care (PAC) spending, industry experts from the USC-Brookings...

91% of Eligible Clinicians Participated in 2017 MIPS Reporting


Approximately 91 percent of all eligible clinicians participated in 2017 Merit-Based Incentive Payment System (MIPS) reporting, exceeding the CMS goal of 90 percent participation in the first year of the Quality Payment Program, the...

Value-Based Care Driving Independent Practices to Consultants


Independent physicians and practices are turning to consultants to make the transition to value-based care and stay competitive in a shifting market. The latest research from Black Book shows physician-led practices have turned the tide...

New Org Aims to Help Independent Practices with Value-Based Care


The value-based care transition has been a thorn in the side of independent practices, but a group of leading provider organizations is aiming to better support solo practices in the current healthcare landscape through the formation of a...

Only 4 CMMI Alternative Payment Models Met Spending, Quality Goals


The CMS Innovation Center is on the path to reducing healthcare costs while improving care quality through alternative payment and care delivery models, a recent Government Accountability Office (GAO) report found. But only four...

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


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, and several other of healthcare’s...

Provider Orgs Push for 90-Day MIPS Reporting Period in 2018


Almost 50 provider groups are calling on CMS to reduce the Merit-Based Incentive Payment System (MIPS) reporting period from a full calendar to a minimum of 90 days during the 2018 performance year. Among the groups advocating for...

Emory Healthcare, Walmart Team Up for an ACO, Bundled Payments


Atlanta-based Emory Healthcare recently announced the creation of an accountable care organization (ACO) with retail giant Walmart, known as the Accountable Care Plan. Walmart employees at 55 Walmart, Sam’s Club, and Walmart...

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