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

Value-Based Care News

HCTTF Helps Providers Find Value-Based Purchasing Partnerships

February 19, 2019 - A new open-sourced tool from the Health Care Transformation Task Force (HCTTF) is helping providers and payers assess value-based purchasing partnerships. The Partnership Evaluation Tool is a new resource that allows healthcare stakeholders to evaluate a potential partner’s core value-based care competencies. The tool, which is available for free download on HCTTF’s...


Humana Brings Value-Based Care to Independent Practices in 3 States


Humana is helping bring value-based care to independent practices in Louisiana, Pennsylvania, and West Virginia. The Louisville, Kentucky-based payer announced a new value-based care arrangement with physicians in Aledade’s...

AHA Wants More Alternative Payment Models for Rural Hospitals


In its 2019 Rural Advocacy Agenda, the American Hospital Association (AHA) called for more opportunities for rural hospitals to successfully participate in bundled payment models, the Quality Payment Program, and other alternative payment...

AMGA: Full MACRA Implementation Needed to Advance Value-Based Care


AMGA is urging Congress to enforce MACRA implementation as policymakers intended by no longer excluding providers from the Merit-Based Payment Incentive Program (MIPS). “MIPS was designed as a viable transition tool to value-based...

Only 13% of Hospital CFOs Prepared for Value-Based Reimbursement


Fewer hospital CFOs are prepared to manage the financial impact of evolving business conditions, such as value-based reimbursement and care delivery models, a new survey finds. Consulting firm Kaufman Hall recently surveyed CFOs and other...

HHS Sets New Priorities for Physician-Focused Payment Models


Healthcare stakeholders looking to develop their own alternative payment models for HHS implementation should look to new guidance before submitting their applications to the Physician-Focused Payment Model Technical Advisory Committee...

GAO: Advantages of Voluntary and Mandatory Bundled Payments


Voluntary and mandatory bundled payment models each have their own pros and cons. But providers like voluntary models because they offer more favorable financial terms, a new Government Accountability Office (GAO) report showed. “In...

More Groups Want to Extend Medicare Shared Savings Program Deadline


Eleven healthcare industry groups are supporting the National Association of ACOs’ (NAACOS) call for CMS to extend the Feb. 19 application deadline for the Medicare Shared Savings Program (MSSP). CMS announced earlier this month...

Rural, Small Practice MIPS Performance Lagged Behind Large Peers


Rural and small practices fared worse than their large peers in MACRA’s Merit-Based Incentive Payment System (MIPS) in 2017, new research shows. Nearly one in five small practices received a negative MIPS payment adjustment compared...

Beta Testing Alternative Payment Models to Advance Value-Based Care


Forcing providers to participate in alternative payment models (APMs) will do little to incentivize providers to make the care delivery and payment changes needed to reduce costs and improve quality, experts at the Center for Healthcare...

67% of MSSP ACOs May Be High-Revenue Under Pathways to Success


Over two-thirds of Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) would qualify as high-revenue organizations under the new Pathways to Success initiative, a recent Leavitt Partners analysis...

CMS Announces Feb 19 Deadline for Pathways to Success Applications


Accountable care organizations (ACOs) can start their Pathways to Success applications to participate in the initiative replacing the Medicare Shared Savings Program (MSSP) in the summer of 2019. The organizations will have between Jan. 22...

Are Hospital Readmissions Reduction Program Results Overstated?


CMS, researchers, and other healthcare stakeholders have touted the Hospital Readmissions Reduction Program (HRRP) touted as a success. Under the authority of the Affordable Care Act, CMS launched the HRRP in 2010 to incentivize hospitals...

Social Determinants of Health Key to Value-Based Purchasing Success


We are quickly heading to the value-based purchasing tipping point, according to the Vice President of Network Management at Health Partners Plans in Pennsylvania. “While adoption rates are still relatively low in some regions of...

ACO Financial Risk Rules for Pathways to Success Raise Concerns


Leading healthcare industry groups are concerned that the overhaul of the Medicare Shared Savings Program (MSSP) will impede the transition to value-based care. On December 21, 2018, CMS finalized changes to the largest Medicare...

Next Generation Accountable Care Organizations Save $164M


Accountable care organizations (ACOs) assuming the highest levels of financial risk in Medicare saved $164 million during their second performance year, CMS recently reported. Medicare ACOs bring together groups of physicians, hospitals,...

Key Providers, Payers Tie 47% of Business to Value-Based Payment


A large group of major healthcare payers and health systems are reporting that nearly half of their business rests in value-based payment arrangements. The Health Care Transformation Task Force (Task Force) is a group of leading...

MSSP Accountable Care Organizations Saved Medicare Nearly $2.7B


Accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) saved more than previously thought, according to a new analysis. The updated analysis of MSSP ACO savings from the National Association of ACOs (NACCOS)...

Value-Based Care, Price Transparency Rule Top Stories of 2018


2018 has kept healthcare revenue cycle management and finance leaders on their toes. The healthcare industry continued its slow, but steady transition to value-based care and purchasing all while navigating the new landscape of healthcare...

Healthcare Interoperability, Rule Reform Key to Value-Based Payment


Healthcare interoperability is vital to the transition to value-based payments, the second in command at HHS recently stated at the Office of the National Coordinator for Health Information Technology (ONC) annual...

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