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

Value-Based Care News

Time Helps Accountable Care Organizations Realize Savings in MSSP

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Experience is a key factor to realizing greater cost savings in the Medicare Shared Savings Program (MSSP), a new Avalere analysis found. Accountable care organizations (ACOs) in the MSSP for four or more years generated nearly all of the...

Hospitals Seek Non-Acute, Supplier Partners for Value-Based Care

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Hospitals are looking to strategically expand their footprint in the non-acute care space to succeed in value-based care and alternative payment models, a new study of hospital decisionmakers found. L.E.K.’s ninth annual...

Medicare Spending Falls 3.3% in First Year of CJR Bundled Payments

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Hospitals reduced average Medicare spending on lower extremity joint replacements (LEJRs) by 3.3 percent during the first performance year of Medicare’s mandatory bundled payments model for joint replacements, CMS recently...

New Alternative Payment Model Tackles Holistic Addiction Recovery

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A national multi-sector alliance of healthcare industry leaders is looking to incentivize providers and payers to deliver coordinated, holistic addiction recovery services to patients through a new alternative payment model. Nearly 21...

MSSP ACOs Saved $1.84B, Nearly Double CMS Estimate, Study Finds

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CMS estimates that accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) saved $954 million from 2013 to 2015. However, a new Dobson DaVanzo & Associates analysis, commissioned by the National Association...

Developing a 2018 MIPS Reporting Strategy to Avoid a Penalty

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Eligible clinicians can avoid a financial penalty under the Merit-Based Incentive Payment System (MIPS) in 2020 by focusing their reporting on one of three performance categories: Quality, Improvement Activities, or Promoting...

How Next Generation ACOs Built a Foundation for Success

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Employing additional administrative staff, prioritizing care management, and building data analytics capacity were key strategies accountable care organizations (ACOs) implemented to participate in the Next Generation model, CMS recently...

More MSSP ACOs Saved Money, Earned Shared Savings in 2017

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Accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) generated about $314 million in net Medicare savings in 2017, according to new MSSP performance data from CMS. In 2017, 472 ACOs in the largest Medicare...

ACOs Relax Post-Acute Care Rules to Improve Care, Reduce Costs

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Ensuring patients receive the right post-acute care at the right time is key to controlling costs in accountable care organizations (ACOs) and other population-based alternative payment models. With this in mind, Vermont’s statewide...

Value-Based Experience, Robust EHR Use Key Factors to ACO Success

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A collaborative culture, prior value-based reimbursement experience, and robust EHR use are among the top factors contributing to accountable care organization (ACO) success, according to a new report from the Patient-Centered Primary Care...

Do Proposed Quality Payment Program Changes Support Specialists?

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The American Society of Clinical Oncology (ASCO) recently expressed their concerns with proposed Quality Payment Program changes, arguing the potential implementation policies for the third year of the program do not align with specialty...

After a Slow 2017, ACOs Grow and Expand Their Contracts in 2018

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The number of accountable care organizations (ACOs) continued to grow in 2018, as did the number of contracts the organizations entered, a new report from Leavitt Partners and the Accountable Care Learning Collaborative uncovered. From...

Academic Medical Centers Receive More Value-Based Penalties

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Academic medical centers (AMCs) are key members of the healthcare industry, engaging in medical research, uncovering clinical breakthroughs, and training future providers. However, a new analysis by Navigant shows that the organizations...

Employers Play Bigger Role in Value-Based Reimbursement Transition

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Providers wanting to expand their value-based reimbursement contracts may want to look to the employer-sponsored health plan market, according to a new report from the Duke-Margolis Center for Health Policy and the Robert Wood Johnson...

Docs, Payer Execs Agree Providers Lack Tools for Value-Based Care

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A lack of technology and patient data may be stalling or even reversing the value-based care transition, a new survey of primary care physicians and health plan executives revealed. “Stalled Progress on the Path to Value-Based...

EHR Costs, Staffing Still Trouble Small, Rural Practices in MIPS

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Financial challenges plaguing small and rural practices under legacy Medicare value-based purchasing programs are likely to persistent under the Merit-Based Incentive Payment System (MIPS), the Government Accountability Office (GAO)...

More Execs Expect Value-Based Reimbursement to Up Profitability

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Approximately 46 percent of healthcare executives and managers expect value-based reimbursement contracts to improve their organization’s profitability, according to a recent KPMG survey. Healthcare leaders are more optimistic about...

ACOs and Other Value-Based Purchasing Models Have Yet to Cut Costs

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Accountable care organizations (ACOs) and other population-based value-based purchasing models have not decreased total cost of care or generated quality improvements at the market level, a new study found. The Healthcare Financial...

How Addressing Social Determinants of Health Cuts Healthcare Costs

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Population health management and value-based reimbursement success hingeĀ on reducing healthcare costs not only when a patient is in the exam room, but also when they are beyond the walls of the practice or hospital. Therefore,...

Value-Based Care Reduces Costs by 5.6%, Improves Care Quality

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Value-based care strategies are starting to achieve the goals of the Triple Aim, payers reported in a new ORC International study commissioned by Change Healthcare. The analysis of 120 payers across a range of organization size and type...

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