Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Value-Based Care News

Population Health Helps Medicare ACO Models Earn Shared Savings

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Medicare ACO models operating through the Medicare Shared Savings Program have faced some significant challenges in garnering shared savings and taking on more financial risk. With multiple programs competing for funding from the Centers for...

Quality Metrics Pose Problems for Value-Based Care Reimbursement

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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...

Payers Benefit from Aligning with MIPS, Value-Based Care

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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...

Premier Accountable Care Organizations Improved Quality in 2015

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New results from the Premier Inc. Population Health Management Collaborative (PHMC) show that accountable care organizations (ACOs) within the collaborative improved quality and cost reduction in 2015 better than other ACOs operating through...

How to Favorably Manage Risk in Value-Based Care Reimbursement

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While downside risk does not incentivize providers to take part in value-based care reimbursement policies, data-driven technology and a combination of financial motivations may encourage physicians to transition to alternative payment models,...

Why Reviewing Pricing Trends is Key for Bundled Payment Models

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When payers begin to adopt bundled payment models, they may find some challenges standing in their way to truly succeed within these alternative payment solutions. For example, when attempting to contract through bundled payments, it may be difficult...

How Payers Could Adjust to MACRA Regulations, Value-Based Care

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MACRA regulations may seem overly complex and lengthy for the average medical practice but there are steps that providers can follow to succeed under MACRA’s quality payment program. Providers can work with payers to better identify similar...

Care Coordination Vital in Accountable Care Organizations

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Healthcare payers looking to transition to new payment systems and better coordinate care across multiple facilities would benefit from working within accountable care organizations (ACOs). Within ACOs, payment is linked to quality performance...

How MACRA Legislation Advances Value-Based Care Reimbursement

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MACRA legislation may play a major part in advancing the adoption of value-based care reimbursement among both payers and providers. CMS Acting Administrator Andy Slavitt emphasized this past May that MACRA legislation will bring real progress...

Blue Cross to Expand Value-Based Care Reimbursement in 2017

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The coming years will further position the medical industry including payers to adopt value-based care reimbursement models and new healthcare delivery systems partially due to the reforms that came about from the Patient Protection and Affordable...

How Blue Cross Blue Shield Achieved Value-Based Care Payment

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The transition to value-based care payment from fee-for-service payment methodology has come about due to the constant rise of healthcare spending. In fee-for-service, healthcare providers are incentivized to perform more services and offer often...

Accountable Care Organizations Expand Use of Social Services

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Today, accountable care organizations (ACOs) are focused on expanding their coordination efforts with social service agencies and community resources, according to findings from a report completed by the Premier Research Institute and the Robert...

25% of Health Plans Implement Alternative Payment Models

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Among commercial health plans, Medicare Advantage, and Medicaid markets, approximately 25 percent of reimbursement is expected to be in the form of alternative payment models by the end of 2016, according to a new report from the Health Care...

Commercial Payers Behind CMS in Bundled Payment Models

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The Centers for Medicare & Medicaid Services (CMS) have heavily invested in pursuing bundled payment models as an alternative form of payment for medical care among Medicare beneficiaries. Commercial payers, however, have been more slow to...

Why Accountable Care Organizations Should Adopt Bundled Payment

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The Centers for Medicare & Medicaid Services (CMS) should consider allowing Track 1, 2, and 3 accountable care organizations (ACOs) to participate in cardiac and comprehensive joint replacement bundled payment models, according to a comment...

Payers Slow to Adopt Value-Based Care Payment Arrangements

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A new survey from the healthcare alliance Premier found that healthcare payers are not transitioning to value-based care payment arrangements as quickly as medical providers would like, according to a company press release. With the Centers for...

Private Payers Follow CMS Lead, Adopt Value-Based Care Payment

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Commercial payers are following the lead of the Centers for Medicare & Medicaid Services (CMS) when it comes to adopting value-based care payment protocols. More private payers have implemented various value-based CMS programs such as accountable...

Latest CMS Bundled Payment Strategies May Need Revision

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The Health Care Incentives Improvement Institute has found problems with some of the latest bundled payment strategies coming from the Centers for Medicare & Medicaid Services (CMS) including flaws surrounding clinic-centric control of the...

How Payers Could Meet Employer Needs in Bundled Payment Models

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While the number of bundled payment models adopted by hospitals and payers is growing, implementation of value-based care is an innovative and modern idea that many healthcare providers are still unfamiliar with. For instance, bundled payments...

3 Key Steps for Payers to Succeed in Value-Based Care Payment

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Commercial health insurance companies have little reason to remain attached to fee-for-service payment systems since the rate of healthcare costs continues growing and the healthcare industry as a whole is moving toward value-based care reimbursement....

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