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

Value-Based Care News

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

April 23, 2018 - 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 Distribution Center locations in the metro-Atlanta region have been able to enroll in the Accountable Care Plan since Jan. 1, 2018. The employees in the ACO program...


Only 37% of MIPS Quality Measures Deemed Valid by ACP


The American College of Physicians (ACP) is calling for a “time-out” to assess and improve Merit-Based Incentive Payment System (MIPS) quality measures after finding few of the measures used to determine clinician performance and...

Practices Push for Quicker Value-Based Purchasing Transition


The Council of Accountable Physician Practices (CAPP) recently urged policymakers to prioritize the value-based purchasing transition by accelerating the shift away from fee-for-service. “We recognize that much of policymakers’ and...

MSSP ACOs Fell $2B Short of CBO’s Medicare Spending Estimate


A new analysis from Avalere showed that Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) failed to reduce Medicare spending as the Congressional Budget Office (CBO) projected in 2010. The CBO estimated that the...

Uniform Operational System Key to Value-Based Payments, CAQH Says


The healthcare industry needs an “efficient, uniform operational system” to sustain value-based payment success, the Council for Affordable Quality Healthcare’s (CAQH) Committee on Operating Rules for Information Exchange (CORE)...

MD All-Payer Alternative Payment Model Met Medicare Spending Goal


The Maryland All-Payer alternative payment model has already met and exceeded its five-year goal of reducing Medicare spending on hospitals by $330 million and the state is on its way to achieving care quality improvement goals, the state’s...

MIPS Will Impede Value-Based Purchasing Transition, MedPAC Argues


The Medicare Payment Advisory Commission (MedPAC) recently suggested that Congress repeal the Merit-Based Incentive Payment System (MIPS), arguing the new value-based purchasing program “impedes the movement toward high-value care.”...

Should Congress Repeal the Merit-Based Incentive Payment System?


As over 400,000 eligible clinicians prepare to submit data to the Merit-Based Incentive Payment System (MIPS) by the end of March, industry experts are urging policymakers and HHS officials to reconsider and even repeal MACRA’s most popular...

Accelerating the Value-Based Payment Transition Top HHS Priority


Quickening the pace of the value-based payment transition is a major focus for HHS, the department’s new Secretary Alex Azar recently told attendees of the Federation of American Hospitals’ annual Public Policy Conference in Washington...

72% of Medical Groups Oppose Mandatory Alternative Payment Models


The mandatory versus voluntary alternative payment model debate continues. This time medical group practices are voicing their opinions in a new MGMA Stat poll that found 72 percent of group leaders oppose required participation in Medicare alternative...

Value-Based Purchasing Top Health Reform Priority for Governors


In a recent healthcare reform proposal, a bipartisan group of governors emphasized that value-based purchasing implementation will be the key to reducing healthcare costs while improving outcomes. “Coverage is important, and coverage reforms...

Orgs Push for MSSP Track 1 Extension for Non-Risk-Bearing ACOs


Six healthcare industry groups are urging CMS to extend participation in the Medicare Shared Savings Program (MSSP) Track 1 beyond two agreement periods to allow accountable care organizations (ACOs) more time to assume downside financial risk....

Slow and Steady Still the Motto for Value-Based Reimbursement


The healthcare industry has boarded the train to value-based reimbursement. But recent roadblocks have provider organizations pumping the brakes with the shift away from fee-for-service, explained industry experts Doral Jacobsen, MBA, FACMPE,...

MSSP ACOs Save More By Spending Less on Inpatient, Post-Acute Care


Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) have shifted their spending to physician services and away from inpatient and skilled nursing facility care, according to a recent study in the American Journal of Accountable...

Hospital Execs, Payers Face Similar Value-Based Purchasing Barriers


Payers and hospital finance executives agree that health IT inadequacies and insufficient physician buy-in are top barriers to value-based purchasing adoption, two recent surveys revealed. The Healthcare Financial Management Association’s...

Login, Submit Data Early for MIPS Reporting Success, CMS Advises


Eligible clinicians should log into the reporting system and upload 2017 performance data as soon as possible for Merit-Based Incentive Payment System (MIPS) reporting success, CMS recently suggested in an email. Eligible clinicians reporting...

Doctors, Employers Disagree on Healthcare Payment Reform Strategy


Healthcare providers and employers are moving to value-based reimbursement models to achieve the Triple Aim, but the stakeholders disagree on how to move healthcare payment reform efforts forward and by what means, a recent Leavitt Partners survey...

Reducing Low-Value Care Key to Value-Based Reimbursement Success


Value-based reimbursement success hinges on decreasing low-value care across patient populations, explained Scott Weingarten, MD, MPH, Senior Vice President and Chief Clinical Transformation Officer at Cedars-Sinai Medical Center. While hospitals...

AMGA: Link Spending, Quality Performance for True Value-Based Care


In response to a Request for Information from the Assistant Secretary for Planning and Evaluation (ASPE), AMGA recently called on CMS to “define value in a meaningful way” to ensure value-based care models incentivize providers to...

Clinicians, MedPAC Criticize the Quality Payment Program, MIPS


Almost three-quarters (71 percent) of clinicians are “not very comfortable” or “not comfortable at all” with new measures under MACRA’s Quality Payment Program, and about 62 percent perceive the program’s measures...

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