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

Value-Based Care News

Wisconsin Hospital Questions Hospital Profitability Study


In a hospital profitability study, researchers from Health Affairs drew the conclusion that Gundersen Lutheran Medical Center earned a profit of $302.5 million, or $4,241 per patient, in 2013. However, Gundersen Lutheran Medical Center claimed...

FTC: Hospital Mergers and Acquisitions May Create Monopolies


Antitrust laws that prevent the formation of healthcare monopolies due to large-scale hospital mergers and acquisitions must be enforced in order to prevent skyrocketing healthcare costs, said Federal Trade Commission Chair Edith Ramirez at a...

Providers Spend $15.4B to Report on Healthcare Quality Measures


General internists, family physicians, cardiologists, and orthopedists spend more than $15.4 billion annually to report on healthcare quality measures set by payers, according to a report from Health Affairs. Annually, these four types of practices...

Mixed Results for MSSP Accountable Care Organization Savings


According to a report from Leavitt Partners, 42 percent of accountable care organizations (ACO) residing in high-cost markets in the Medicare’s Shared Savings Program (MSSP) earned shared savings, while only 18 percent of organizations...

5 Ways to Improve Healthcare Supply Chain Management


In this age of payment reform, it’s vital for healthcare supply chain management to be effective if healthcare executives want to reduce costs and improve quality. An efficient supply chain has the ability to improve the delivery of healthcare...

Providers Prioritize Quality Care, Not Lower Healthcare Costs


By now, many healthcare providers are partaking in some form of value-based care, which aims to foster quality care while reducing healthcare costs. To achieve this, value-based care relies on care coordination to decrease unnecessary treatments...

Do Nurse Practitioners Increase Healthcare Spending Rates?


While the use of independent nurse practitioners (NPs) is often seen as an important way to drive down healthcare spending rates, a new report from researchers at the University of California San Francisco indicates that the positive...

Value-Based Care Leads to Higher Costs for Surgical Complications


As a result of recent efforts to bring value-based care to the reimbursement cycle, it’s now more important for both providers and payers to gain an understanding about the link between costs and surgical complications, according to a recent...

5 Ways to Cut Costs through Hospital Revenue Cycle Management


As healthcare costs continue to rise, hospital revenue cycle management has become an important focal point for providers. Healthcare expenditures in the US are projected to reach $4.4 trillion by 2018, according to an article in The American...

High Patient Experience Scores Boost Hospital Net Margins by 50%


Hospitals in the US that provided a “superior” patient experience gained net margins that were 50 percent higher, on average, than those that deliver an “average” customer experience, researchers from Accenture observed....

Post-Acute Care Can Help Accountable Care Organizations Save


As the Center for Medicare and Medicaid Innovation (CMMI) continues to deploy new programs, evidence of the impact of existing models continues to trickle in. One consistent theme: the importance of, and opportunity presented by, improvements...

Anthem Accountable Care Organizations Save $14.8 Million


Four medical groups participating in Anthem Blue Cross accountable care organization (ACO) arrangements were able to save a total of $14.8 million from 2013 to 2014 due to improved coordinated care efforts, according to an Anthem press release....

Number of Accountable Care Organizations Continue to Rise


The number of accountable care organizations (ACOs) continue to increase across the county. Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced 121 new Medicare Accountable Care Organization (ACO) participants. Between...

IRS: Commercial ACO Can’t Claim Charitable Tax Exemptions


An unnamed accountable care organization (ACO) will not be able to claim charitable tax exempt status since its role centered on facilitation instead of the provision of care, the IRS said in a determination letter this month. The ACO, which...

MA Medicaid Proposes $1.5B Investment in Accountable Care


MassHealth, the combine management of Medicaid and Children's Health Insurance Programs by the Commonwealth, is joining the accountable care movement by proposing a major $1.5 billion overhaul of its reimbursement structures. By developing...

CMS Extends Application Period for Next Generation ACO Model


Providers interested in participating in the Next Generation Accountable Care Organization (ACO) program now have until May 20, 2016 to submit their letters of intent, CMS announced this week. In order to apply to the Next Generation ACO Model,...

NAACOS Comments on Accountable Care Organizations Benchmarks


Last month, the National Association of ACOs (NAACOS) submitted comments for the Health Care Payment Learning & Action Network (LAN) Financial Benchmarking Draft White Paper. NAACOS takes on the largest portion of accountable care organizations...

Despite ACA, Emergency Department Visits Remain Numerous


Although policymakers want to see the Affordable Care Act (ACA) lead to a reduction in visits to emergency departments, new data from the Centers for Disease Control & Prevention (CDC) raise concerns about the mandate’s real impact...

Accountable Care Organization Savings Shift After First Year


More than 700 accountable care organizations (ACO) currently work toward the goal of improving the quality of healthcare while also reducing capital costs of healthcare thanks to the Affordable Care Act. Meanwhile, researchers attempt to figure...

Top 5 Ingredients of a Successful Accountable Care Organization


Because of the Affordable Care Act, the healthcare industry continues to move toward value-based care. As a result, Medicare has invested heavily in value-based reimbursement structures, such as accountable care organizations (ACOs), which turn...


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