Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Value-Based Care News

Key Strategies for Transitioning to Value-Based Care Payments

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With value-based care payments impacting both payers and providers around the country as the healthcare industry transitions toward a new climate based on quality of care, preventive services, and better patient outcomes, health insurers must...

Best Practices to Drive HEDIS Success in 2017

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Achieving success requires plans to adhere to annual changes from the National Committee for Quality Assurance (NCQA) related to HEDIS measurement, reporting requirements, and timelines. In addition, health plans can better position themselves...

Why Payers Should Educate Providers on Value-Based Care

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Both private payers and public payers like the Centers for Medicare & Medicaid Services (CMS) have a long road ahead of them in supporting healthcare providers and consumers with the transition to value-based care reimbursement. For example,...

Why Bundled Payments are Essential for Payers to Adopt

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While the Centers for Medicare & Medicaid Services (CMS) was first to implement bundled payments in one of its many programs meant to renovate provider reimbursement processes, private health payers would also benefit from pursuing bundled...

3 Key Strategies for a Successful Payer-Provider Relationship

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What are the key ingredients that health insurance companies need to integrate in order to have a successful payer-provider relationship? There are a number of steps that payers and providers will need to follow in order to improve their working...

How Accountable Care Organizations Use Preventive Services

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What accomplishments have accountable care organizations (ACOs), providers, and payers reached in their effort to operate value-based reimbursement systems? This is the question that many ACOs are answering today. With value-based care reimbursement...

Affordability, Cost Transparency Key for Patient Satisfaction

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The biggest healthcare reforms impacting health payers today include the movement toward consumer engagement and patient satisfaction. Patient advocacy groups are bringing more attention toward keeping the patient voice at the center of healthcare...

Should CMS Incorporate More Bundled Payment Programs?

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Last month, the Center for American Progress (CAP) issued a statement urging the Department of Health & Human Services (HHS) to expand their work in bundled payment programs so that medical costs would decrease and even greater focus can...

Accountable Care Organizations Rely on Population Health Data

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Accountable care organizations (ACOs) are slowly becoming a mainstay of the healthcare industry, as more payers and providers are partnering through these care coordination programs and negotiating value-based reimbursement contracts. However,...

Population Health Vital for Medicare ACO Models to Succeed

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Accountable care organizations (ACOs) have taken on a larger role in delivering services throughout the continuum of care. Initially, these establishments were created under the Medicare Shared Savings Program but have slowly moved toward contracting...

How Quality Metrics Affect Value-Based Care Reimbursement

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In today’s changing healthcare landscape, public and private health payers are attempting to investigate new payment models in order to reduce the continually rising medical spending. Whether it’s bundled payments or accountable care...

How to Strengthen Accountable Care Organizations, MSSP

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Accountable care organizations (ACOs) continue to gain greater acknowledgement within the healthcare industry as the field transitions to value-based care reimbursement and moves away from the fee-for-service payment model. It began with the...

The Role Risk Plays in Value-Based Care Reimbursement Models

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The expansion of value-based care reimbursement is making headway across US hospitals and clinics. To better prepare for the transition to value-based care reimbursement, IDC Health Insights, a healthcare IT consulting company, offers advice...

Value-Based Care Payments May Reach 60% in Next Five Years

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Value-based care payments are quickly becoming a mainstay in today’s health insurance industry with more payers jumping on the bandwagon of bundles, alternative payment models, and accountable care organizations. A report commissioned by...

New Ruling in Medicare Shared Savings Program Changes Payment

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As previously reported, the Centers for Medicare & Medicaid Services (CMS) have finalized a ruling that changes how the Medicare Shared Savings Program operates its payment protocols among accountable care organizations. The change impacts...

Why Maternity Care Needs Episode-Based Bundled Payments

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Episode-based bundled payments are becoming a sought-after reimbursement model throughout the healthcare industry. Along with the Centers for Medicare & Medicaid Services and its focus on implementing bundled payments, private payers are...

Why Accountable Care Organizations May not Succeed in MSSP

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Do accountable care organizations (ACOs) truly save costs for the healthcare industry? Or is forming an ACO in hopes of cutting spending a pipe dream? Last year’s results from the Medicare Shared Savings Program (MSSP) showed little positive...

Humana’s Top Suggestions for Operating Bundled Payment Models

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The major health payer Humana will be moving toward adopting additional bundled payment models that will serve Humana Medicare Advantage members. The payer will be partnering with four orthopedic specialty establishments through these bundled...

Top 3 Ways Accountable Care Organizations Could Garner Savings

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Payers and providers looking to operate through an accountable care organization (ACO) will need to adhere strictly to state and federal laws regarding the development of this model of care. Accountable care organizations are responsible for...

CMS Bundled Payment Program Reduces Costs for Consumer

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At the end of last year, the Centers for Medicare & Medicaid Services (CMS) finalized their bundled payment rule for hip and knee replacement surgery. This type of bundled payment program will hold hospitals more accountable for patient health...

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