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

Value-Based Care News

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...

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...

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...

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...

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...

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...

CMS Welcomes 58 Next Generation ACO Model Participants in 2018


In 2018, the Next Generation ACO model will have a total of 58 participating accountable care organizations (ACOs), up from 45 organizations the previous year, CMS recently announced on the program’s Innovation Center webpage. The...

AMGA: Align Medicare Advantage, APMs to Promote Value-Based Care


If CMS moves forward with relaxing Medicare Advantage benefit requirements, then the federal agency should offer the same flexibilities to providers and beneficiaries in Medicare Part B alternative payment models, such as accountable care...

Mandatory Bundled Payments Drive Value-Based Care, Docs Argue


The recent decision from CMS to cancel two mandatory bundled payments programs slated to launch in 2018 was a “step in the wrong direction for pursuing a healthcare system that focuses on value and not volume,” three physicians...

Limited Quality Benefits for Early Pay-For-Performance Adopters


The impact of hospital pay-for-performance models, such as Medicare’s Hospital Value-Based Purchasing Program (HVBP), have been “limited and disappointing” over the past decade, researchers stated in a new BMJ study. The...

3 Strategies to Reduce Hospital Readmission Rates, Costs


Providers understand that high hospital readmission rates spell trouble for patient outcomes. But excessive rates may also threaten a hospital's financial health, especially in a value-based reimbursement...

Vermont ACO Receives $620M to Lead Healthcare Reform Efforts


Vermont’s healthcare reform group, Green Mountain Care Board, recently approved a budget of $620 million for OneCare Vermont, an accountable care organization (ACO) working with Medicare, Medicaid, and private payers, local news...

Stakeholders Back Standard ACO Measures for Commercial Orgs in CA


The Integrated Healthcare Association (IHA) and Pacific Business Group on Health (PBGH) recently embarked on a joint mission to standardize accountable care organization (ACO) measures for quality and cost performance and benchmarking for...

Nearly 71% of Practice Revenue Under Fee-For-Service in 2016


Fee-for-service was still the dominant source of medical practice revenue in 2016, the American Medical Association (AMA) recently reported. Almost 84 percent of physicians stated that their practice received fee-for-service revenue in...

OIG: Practice Aid, QPP Integrity Needed for MACRA Implementation


A recent Office of the Inspector General (OIG) investigation found two major vulnerabilities with MACRA implementation. The HHS watchdog reported that CMS still needs to provide practice-specific technical assistance and implement a...

Physician-Led Advanced APMs to Support Independent Docs, Orgs Say


CMS should support small and independent practices by developing physician-led Advanced Alternative Payment Models (APMs), advised a group of provider and industry organizations. The American Academy of Family Physicians (AAFP), Medical...

60% of Federal Revenue to Come from Risk-Based Models by 2019


Almost 60 percent of federal revenue and 37 percent of commercial revenue will stem from risk-based models by 2019, according to a new AMGA survey. The survey of 74 AMGA medical groups uncovered that Medicare and Medicaid fee-for-service...

High-Risk Patient Management Did Not Drive Early ACO Cost Savings


Care coordination and care management strategies focused on high-risk and chronically ill patients did not drive early cost savings among accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP), a recent Health...

Key Capabilities for Value-Based Reimbursement Models


Rising healthcare costs, shrinking reimbursement rates, and federal policies are driving hospitals and health systems to adopt value-based reimbursement, according to a new American Hospital Association (AHA) report. But the models are...

High-Value Culture, Population Health Programs Key to ACO Success


Creating a high-value culture, engaging in proactive population health management, and implementing an infrastructure that promotes continuous performance improvement were key characteristics of 11 successful accountable care organizations...

Become a member

Complete your profile below to access this resource.

Thanks for subscribing to our newsletter. Please fill out the form below to become a member and gain access to our resources.

Reset your password

Enter your email address to receive a link to reset your password


Join 30,000 of your peers and get free access to all webcasts and exclusive content

Sign up for our free newsletter:

Our privacy policy

no, thanks

Continue to site...