Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability
  • Why Value-Based Care Reimbursement, MACRA are Here to Stay

    December 5, 2016 - The outcome of the presidential election has led to some uncertainty throughout the healthcare industry when it comes to legislative changes and medical coverage. However, providers and payers will need to keep a clear head in the coming months and remember which legislative achievements and healthcare reforms will likely be here to stay for years to come. For instance, the overall trajectory...

  • Humana Serves 63% of Members through Value-Based Care Payment

    November 30, 2016 - The future for the health insurance industry likely revolves around value-based care payment, which has grown in use steadily over the last several years. Recent healthcare reforms have centered around tracking the quality of care, reducing spending, and improving patient health outcomes. Value-based care payment models tend to revolve around meeting these three goals. Michael Funk, Vice President,...

  • Quality Metrics Pose Problems for Value-Based Care Reimbursement

    November 29, 2016 - The healthcare industry’s fast pace transition to value-based care reimbursement has led to some major challenges for both providers and payers. Adopting completely new payment contracts based on quality metrics is not a simple maneuver for health insurance companies. Providers also find switching from fee-for-service payment systems to reimbursement based on quality care improvements...

  • Payers Benefit from Aligning with MIPS, Value-Based Care

    November 22, 2016 - While healthcare regulations like MACRA legislation often centers around impacting medical providers, the health insurance industry is also integrated into the tapestry of value-based care and alternative payment models. When providers start adopting the requirements of the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs), healthcare payers would be...


Today's Top Stories

Why Value-Based Care Reimbursement, MACRA are Here to Stay

The outcome of the presidential election has led to some uncertainty throughout the healthcare industry when it comes to legislative changes and medical coverage. However, providers and payers will need to keep a clear head in the coming months...

CMS Commits to Improved Care Quality, Medical Spending Cuts

The Centers for Medicare & Medicaid Services (CMS) will continue to work toward creating a better healthcare system for patients while keeping close track of medical spending regardless of which political party is in charge, said Andy...

UnitedHealth Group Adopts Bundled Payment Models for Surgeries

The commercial payer UnitedHealth Group has begun expanding its involvement in bundled payment models. Forbes reported that UnitedHealth will be implementing bundled payment models for spinal surgeries as well as hip and knee replacement operations...

Health Payer Solutions for Improving HEDIS Quality Scores

Payers and providers transitioning to value-based care reimbursement need to commit to meeting and improving their HEDIS quality scores. However, the documentation involved in reporting HEDIS quality scores tends to become complex. Johns...

How Health Payers Could Help Reduce High Out-of-Pocket Costs

A major problem still impacting consumers within the health insurance market is the potential for seeing high out-of-pocket costs. Many individuals are still underinsured despite the significant decrease in the uninsured rate around the country...

How Payers Could Gain Success in Value-Based Care Models

Value-based care models are on their way to becoming the main form of reimbursement between payers and providers especially when considering the goals of the Centers for Medicare & Medicaid Services (CMS) to position 50 percent of Medicare...

Humana Serves 63% of Members through Value-Based Care Payment

The future for the health insurance industry likely revolves around value-based care payment, which has grown in use steadily over the last several years. Recent healthcare reforms have centered around tracking the quality of care, reducing spending,...

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