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

Value-Based Care News

274 Orgs Calls on CMS to Add Medicare Advantage Advanced APMs

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CMS should develop financial incentives comparable to those in the Quality Payment Program’s Advanced Alternative Payment Model (APM) track for providers who assume financial risk under Medicare Advantage plans, CAPG and 273 other...

Premier: Bundled Payment Models Should be Voluntary Nationwide

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Premier Healthcare Alliance recently offered CMS several recommendations for bundled payment model development, including making programs voluntary for providers across the nation. CMS has implemented several mandatory bundled payment...

CMS Reopens Next Generation ACO Application Request Portal

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Providers interested in joining the Next Generation Accountable Care Organization (ACO) model in 2018 can now access the Request for Applications and Letter of Intent on the program’s portal, according to a recent CMS...

AHA Critiques MedPAC’s Potential MACRA Implementation Changes

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The American Hospital Association (AHA) recently responded to potential MACRA implementation changes discussed at the Medicare Payment Advisory Commission’s (MedPAC) January meeting. The industry group called on MedPAC to “draw...

Exploring MIPS Advancing Care Info, Improvement Activities

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At HIMSS17, CMS leaders took the stage to ease provider concerns about the newly launched Quality Payment Program and its more popular value-based reimbursement track, the Merit-Based Incentive Payment System (MIPS). Following up on their...

CMS Calls on Stakeholders for Pediatric APM Development Input

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CMS recently put out a request for information for a potential Medicaid and Children’s Health Insurance Program (CHIP) alternative payment model targeting pediatric care, according to an official CMS blog post. “Through the...

Creating a Population Health Management Operating Model

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ORLANDO - “Collaboration is a critical piece,” Steven Merahn, MD, emphasized during his HIMSS17 session on developing an operating model for population health management that functions regardless of payment model...

CMS Awards $100M for Small, Rural Clinician MACRA Help

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ORLANDO - CMS recently selected 11 healthcare organizations to receive a total of $100 million in funding to help small and rural eligible clinicians participate in the newly-launched MACRA. Each organization received $20 million to...

Coalition Offers CMMI, Alternative Payment Model Improvements

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Thirty-five healthcare industry groups recently banded together to offer the newly-approved Department of Health and Human Services (HHS) Secretary a set of guidelines for CMS Innovation Center (CMMI) and alternative payment model...

FFS, Risk-Based Medicaid ACO Programs Similarly Reduce Costs

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In a comparison of two state Medicaid Accountable Care Organization (ACO) programs, researchers in a JAMA Internal Medicine study found that Oregon’s global capitation ACO model produced similar healthcare savings and care quality...

One-Third of Healthcare Execs Ready for MACRA Implementation

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Only 35 percent of healthcare executives said that their organization has a MACRA implementation strategy and feels prepared for the new value-based reimbursement program, according to a recent Health Catalyst and peer60 survey. The...

2012 MSSP ACOs Decreased Post-Acute Care Spending by 9%

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A new JAMA Internal Medicine study showed that Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) established in 2012 decreased post-acute care spending by a 9 percent differential reduction by 2014 without...

Stakeholders Propose 4 MACRA Physician-Focused Payment Models

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MACRA’s Quality Payment Program offers 5 percent maximum incentive payments if eligible clinicians sufficiently participate in an Advanced Alternative Payment Model (APM) from 2017 to 2022. But many specialists are still waiting for...

Key Considerations for Bundled Payment Model Adoption, Success

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As the value-based reimbursement transition pushes on, many provider organizations have turned to bundled payment models as a stepping stone to alternative payment model adoption. “Bundled payments can be an organization’s...

How Radiologists Can Join an Advanced Alternative Payment Model

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Radiologists may want to look to the physician-focused payment model path in MACRA to develop specialty-specific Advanced Alternative Payment Models (APM), suggested a recent Journal of the American College of Radiology report. Harvey L....

Maryland All-Payer APM Reduces Medicare Hospital Costs by $429M

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As the Maryland All-Payer alternative payment model starts its fourth year, a Health Affairs report shows that the program reduced Medicare hospital costs by $429 million, exceeding CMS requirements that the model save $330 million five...

Patient Care Navigation Program Reduces Cancer Care Costs

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Using non-physician and nurse providers as part of a patient navigation program can significantly lower healthcare costs and utilization for cancer patients while generating a return on investment, a recent JAMA Oncology study...

Industry Orgs Urge Lawmakers to Continue Value-Based Care Push

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Over 120 healthcare industry groups, including hospitals, healthcare systems, payers, and professional organizations, recently urged the Trump administration and Congress to not discontinue or slow the transition to value-based care. In...

CMS Reopens 2018 Next Generation ACO Model Applications

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Providers interested in participating in the Next Generation Accountable Care Organization (ACO) model in 2018 can now submit a letter of intent to CMS, according to the alternative payment model’s webpage. The Next Generation ACO...

359K Clinicians to Join CMS Alternative Payment Models in 2017

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CMS recently announced that the federal agency selected over 359,000 clinicians to participate in four of the federal agency’s alternative payment models in 2017. The new participants will be joining the Medicare Shared Savings...

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