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

Value-Based Care News

Surveys Reveal MACRA Implementation, QPP Knowledge Lacking

June 28, 2017 - Two recent surveys indicated that healthcare provider and executive knowledge of and readiness for MACRA implementation and the Quality Payment Program are lacking despite the value-based reimbursement program launching in January 2017. A new Nuance Communications survey revealed that 61 percent of hospital finance executives are confident that they understand MACRA implementation and Quality...


Articles

Payer Collaboration Key to Value-Based Reimbursement Strategy

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Value-based reimbursement arrangements come in a myriad of shapes and sizes much like provider organizations. But successful value-based contracts will align provider and payer goals for care quality and healthcare utilization as well as establish...

Exploring Quality Measures Under Value-Based Purchasing Models

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CHICAGO – Jason Goldwater, MPA, MA, Senior Director of the National Quality Forum, recently likened the value-based purchasing transition to the evolution of music at Xtelligent Media’s Value-Based Care Summit in Chicago. Music started...

Do Financial Benchmarks Truly Measure ACO Savings, Spending?

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Healthcare stakeholders should not use financial benchmarks developed by CMS to evaluate actual accountable care organization (ACO) savings, three Harvard Medical School experts in a recent Health Affairs blogpost. As Medicare ACOs grow in popularity,...

Oncology Care Model Overcomes Specialty Bundled Payment Hurdles

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Episode-based payment models aim to shift financial accountability to providers for furnishing services for specific conditions or procedures. But develop specialty bundled payment models that target clinical areas, such as oncology, have proven...

Targeting Skilled Nursing Facility, ESRD Care Saves ACO $15M

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A Medicare Shared Savings Program (MSSP) accountable care organization (ACO) realized over $15 million in healthcare savings between 2014 and 2015 by improving skilled nursing facility utilization and targeting end-stage renal disease care, a...

AHA to IRS: Foster Hospital Participation in Commercial ACOs

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The American Hospital Association (AHA) recently called on leaders from the Department of Treasury and IRS to issue formal guidance that would permit non-profit hospitals to participate in commercial accountable care organizations (ACOs) without...

Patient Engagement Critical to Bundled Payment Model Success

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Under bundled payment models, healthcare providers take on the clinical and financial risk payers traditionally managed. But providers at OrthoCarolina found that patients also play a major role in improving care quality and decreasing healthcare...

Providers Lack Tools, Payer Alignment for Value-Based Purchasing

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Healthcare providers still lack the necessary tools for value-based purchasing success with only 43 percent of providers reporting that they have access to the appropriate solutions, a recent Quest Diagnostics and Inovalon survey uncovered. However,...

Count Medicare Advantage Patients for Advanced APMs, Orgs Say

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Eligible clinicians participating in appropriate alternative payment models under a Medicare Advantage plan should qualify for Advanced Alternative Payment Model (Advanced APM) incentive payments in 2019, the AMGA and nine other healthcare industry...

Lab Experts Help Providers Reduce Low-Value Resource Use, Costs

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Collaboration between laboratory medicine experts and clinicians is critical to reducing unnecessary and low-value resource use for value-based purchasing success, the American Association For Clinical Chemistry (AACC) recently stated. “The...

87% of Practices Not Adding Staff for MACRA Implementation

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About 87 percent of physician practices do not plan on hiring additional healthcare staff to help with MACRA implementation, a recent Physicians Practice survey showed. The survey of over 1,000 practice managers and physicians revealed that most...

Commitment Key to Successful Value-Based Reimbursement Adoption

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It is time for healthcare providers to move past understanding the concept and start the value-based reimbursement adoption process. Otherwise, they may face profitability decreases from operating both fee-for-service and alternative payment...

Data Analytics, Collaboration Critical to MACRA Implementation

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Healthcare providers need to restructure many aspects of their organization for successful MACRA implementation, including data analytics capabilities, financial risk assumption, stakeholder partnerships, and patient engagement strategies, according...

Execs To Continue Value-Based Purchasing Despite Uncertainty

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Despite a possible Affordable Care Act repeal, healthcare executives still plan to stay the course with value-based purchasing implementation and healthcare cost reduction initiatives, a recent BDC Advisors survey reported. Although the C-suite...

Post-Acute Care Costs by Market Affect Bundled Payment Models

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A recent study in Medical Care found that post-acute care variations by healthcare market significantly impacted total episode costs in 30-day hip and knee replacement bundled payment models, suggesting financial strategies should focus on high-utilizers...

10 Orgs Call for Medicare Advantage APMs to Qualify for MACRA

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A coalition of ten healthcare industry groups recently urged HHS Secretary Tom Price to weigh risk-based Medicare Advantage alternative payment models the same as Advanced Alternative Payment Models under MACRA. Qualifying participants in MACRA’s...

Key Capabilities for Population-Based Alternative Payment Models

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To succeed in population-based alternative payment models with two-sided financial risk, health systems should embrace assuming the role of the payer and work to get all staff on board with the model, suggested Jackie Selby, a healthcare and...

Execs Say Value-Based Purchasing to Hit Tipping Point by 2020

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Over one-half (55 percent) of healthcare executives surveyed after the recent presidential election stated that the industry should reach the value-based purchasing tipping point before 2020, a recent Lazard report revealed. The survey of 203...

Engaging Providers Key to Value-Based Reimbursement Adoption

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Nearly three-quarters (73 percent) of providers prefer a fee-for-service model over value-based reimbursement structures even though almost one-half acknowledged that the traditional payment model contributed to higher healthcare costs, a recent...

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