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

Value-Based Care News

AMGA Voices Concerns Over Cardiac Care Bundled Payments Model

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With the comment period on a proposed cardiac care bundled payments model closing earlier this week, the American Medical Group Association (AMGA) penned a letter to CMS Acting Administrator Andy Slavitt critiquing the mandatory Medicare demonstration....

CMS Selects 2 Orgs to Provide MACRA Implementation Support

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CMS will award up to $5 million to the Virginia Cardiac Service Quality Initiative and the American Psychological Association  to provide primary and specialist care providers with MACRA implementation support.  The two organizations...

Are Medicare Value-Based Penalties Fair to Safety Net Hospitals?

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Safety-net hospitals have to work harder to avoid value-based penalties than other participants in a Medicare program designed to reduce hospital readmissions, a new study in Health Affairs indicates. While safety-net hospitals have made significant...

Few Docs Familiar with MACRA, Transitioning to Value-Based Care

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Only 20 percent of physicians reported that they are very or somewhat familiar with MACRA, according to a recent survey from the Physicians Foundation and Merritt Hawkins, and the majority of respondents do not currently have a large portion...

Challenges, Successes of First-Year Shared Savings ACOs

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Participants in the Medicare Shared Savings Program (MSSP) already familiar with physician practice transformation were more likely to earn shared savings payments, which should lead the Centers for Medicare & Medicaid Services to focus on...

How Pioneer ACOs Earn Shared Savings, Improve Care Quality

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Massachusetts-based Atrius Health successfully managed several care quality improvements over the previous year and earned both the recognition of CMS and a portion of shared savings as a participant in the Pioneer ACO Model program. In August,...

Post-Acute Care Groups Oppose Value-Based Purchasing Program

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Eight healthcare industry groups recently told lawmakers that they oppose the proposed Medicare Post-Acute Care Value-Based Purchasing Program, which is scheduled to start on Oct. 1, 2019. In a letter to the House Committee on Ways and Means,...

CMS: Bundled Payments Model Will Decrease Medicare Spending

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The Bundled Payments for Care Improvement initiative has the potential to significantly reduce Medicare spending on 11 of 15 clinical episode groups that were analyzed in the program’s second annual evaluation report. In an official CMS...

Next Generation Model Methodology May Boost MSSP ACO Success

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CMS should use a modified Next Generation model benchmark methodology to calculate healthcare cost thresholds to ensure all accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) have an equal opportunity to earn...

Value-Based Care Analytics Help Cut Healthcare Costs in Utah

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By implementing a data analytics tool that integrates spending and patient outcome data, a Utah-based healthcare system reduced spending by up to 11 percent on three clinical improvement projects, including joint replacement, laboratory utilization,...

Preventable Readmissions Drop Under Value-Based Care Model

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Forty-nine states and Washington DC have decreased preventable hospital readmissions under a Medicare value-based care initiative that financially penalizes hospitals with excess readmissions, reported CMS. “The Hospital Readmissions Reduction...

AMGA: New MACRA Flexibilities May Penalize Prepared Providers

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New MACRA flexibilities for the first performance year of the program may help some providers ease into new value-based reimbursement programs, but the American Medical Group Association (AMGA) recently argued that new attestation tracks may...

Are Federal Value-Based Care Programs Truly Promoting Value?

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In a statement to the House Ways and Means Health Subcommittee, the American Hospital Association (AHA) argued that Medicare value-based reimbursement programs, particularly pay-for-performance initiatives, do not have effective and fair financial...

Four New MACRA Tracks Allow Flexible Attestation for Providers

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Eligible clinicians will be able to select their own pace for MACRA attestation to ensure all participants can succeed under new value-based reimbursement programs, CMS announced. On its official blog, the head of CMS detailed four options for...

House Reps Ask CMS for MACRA Implementation Flexibilities

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Representatives from the House Ways and Means Committee and the House Energy and Commerce Committee have penned a letter to HHS Secretary Sylvia Mathews Burwell calling for more flexibilities with MACRA implementation. With the value-based care...

CMS Touts Progress of State-Led Alternative Payment Model

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States participating in the first phase of the State Innovation Model Initiative have made significant progress in implementing alternative payment models, CMS officials revealed midweek. Two of six states were able to link more than half of...

How to Plan Out the Transition to Value-Based Reimbursements

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Providers should address the drivers of value-based reimbursements to appropriately pace their transition to alternative payment models without sacrificing crucial fee-for-service revenue, according to  a new guide from Pershing Yoakley...

Industry Groups Call on CMS to Modify MACRA Patient Codes

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Proposed patient relationship codes that will be used under MACRA to measure appropriate resource use and determine value-based reimbursement adjustments may cause more confusion for providers and increase administrative burdens, according to...

Is MACRA a Trojan Horse for Small Practices, Value-Based Care?

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While a final rule on MACRA implementation has yet to be issued, some providers are growing concerned that the value-based care models in the legislation could significantly burden small physician practices. Providers in small practices will...

Medical Device Reps in OR Sway Healthcare Supply Chain Costs

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Medical device sales representatives may act as key resources for surgeons on the latest technological advances and how to properly use specific devices, but the close relationship may actually be driving up healthcare supply chain costs, according...

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