Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Medicare

Will Changes in Medicare Part B Drug Prescribing Cut Costs?

by Vera Gruessner

The Centers for Medicare & Medicaid Services announced last week that new healthcare payment models would be utilized in Medicare Part B drug prescribing practices. These innovative reimbursement strategies are expected to bring down...

4 Health Payer Industry News Items Revealed at HIMSS16

by Vera Gruessner

With the 2016 HIMSS Conference and Exhibition closing its doors, it grows important to address how the health payer industry remains vital to both the ongoing technology advancements in medicine and patient care in general. Below we...

4 Elements Necessary for Switching to ICD-10 Diagnosis Coding

by Vera Gruessner

On October 1, 2015, the healthcare industry from payers and federal agencies to hospitals, physicians, and specialists transitioned to ICD-10 diagnosis coding. Many healthcare providers were concerned that their practices would not be...

More Part D Beneficiaries Gain Access to Cost-Sharing Pharmacies

by Vera Gruessner

Healthcare access among Medicare and Medicaid beneficiaries remains a top priority for the Centers for Medicare & Medicaid Services (CMS). In 2015, CMS listened to the concerns of many beneficiaries and discovered that many do not have...

HHS Cites Affordable Care Act Led to Prescription Drug Savings

by Vera Gruessner

Yesterday the Department of Health and Human Services (HHS) announced that millions of Medicare beneficiaries continue to see benefits from the Affordable Care Act especially with regard to their savings with prescription drugs....

Merit-Based Incentive Payment System Transforms Meaningful Use

by Vera Gruessner

Last Spring, the Senate and the House of Representatives passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and repealed the former flawed SGR formula. Over the coming years, this law will require healthcare providers...

CMS Released Proposed Rule for Accountable Care Organizations

by Vera Gruessner

Last week, the Centers for Medicare & Medicaid Services (CMS) announced a new proposed rule that would revise the formula used to analyze the performance of accountable care organizations participating in the Medicare Shared Savings...

Physician Leadership Key to Accountable Care Organizations

by Vera Gruessner

The world of accountable care continues to draw interest from healthcare providers and payers alike. Last month, the Centers for Medicare & Medicaid Services (CMS) announced the introduction of 121 new accountable care...

Star Ratings System Created for Medicaid Home Health Services

by Vera Gruessner

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) established a final rule that alters the Medicaid home health services definition to include additional requirements for home care services which expands beyond...

CMS Includes Rich History of Healthcare Bundled Payments

by Vera Gruessner

Recent news shows that the Centers for Medicare & Medicaid Services (CMS) have made real strides in spreading the use of healthcare bundled payments. Not long ago, CMS announced its final rule for the Comprehensive Care for Joint...

Medicare Spending May Increase $500 Billion over Next Decade

by Vera Gruessner

The Congressional Budget Office (CBO) has released information showing growing deficits that are expected to increase by more than $100 billion in 2016 and expand to $1 trillion by 2022. The Committee for a Responsible Federal Budget...

Medicare-Medicaid Financial Alignment Shows Cost Savings

by Vera Gruessner

One program led by the Centers for Medicare & Medicaid Services (CMS) called the Medicare-Medicaid Financial Alignment Initiative moves toward improving the coordination and quality of healthcare services within Medicaid health homes...

CMS Published Final Rule for Surgical Bundled Payment Model

by Vera Gruessner

On January 15, 2016, the final rule for the Comprehensive Care for Joint Replacement model took effect, which is a new reimbursement program for orthopedic surgeries developed by the Centers for Medicare & Medicaid Services (CMS). High...

Accountable Care Organizations’ Rise in Quality a ‘Home Run’

by Vera Gruessner

Recently, the Centers for Medicare & Medicaid Services (CMS) announced that there will be 121 new accountable care organizations participating in the Medicare Shared Savings Program and the Next Generation ACO Model. This means that...

CMS, AMA Delve into Past and Future of Healthcare Market

by Vera Gruessner

Yesterday, representatives from the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association came together to provide an overview of the current healthcare market in a presentation called “A Discussion...

Top Challenges of Alternative Payment Models, Bundled Payments

by Vera Gruessner

The Center for American Progress released a report last Spring that tracks the progress and success of alternative payment models within the Medicare program. The report outlines that a one-size-fits-all strategy is not the right one to...

HHS Announces $157M for Accountable Health Communities Model

by Vera Gruessner

Earlier this week, the Department of Health and Human Services (HHS) announced new funds available of as much as $157 million to develop an Accountable Health Communities Model, which will show whether testing beneficiaries on social needs...

Population Health, Risk-sharing Vital for Accountable Care

by Vera Gruessner

Accountable Care Organizations (ACOs) were established in order to strengthen care coordination among a multitude of medical facilities, improve population health management, and stabilize rising healthcare costs. Through the Medicare...

The Impact of Medicare Advantage Plans, ACOs, Payment Reform

by Vera Gruessner

Now that the New Year is upon us, the Medicare program may be undergoing some significant changes that could affect patients and healthcare services. One ongoing transformative characteristic is the rise in enrollment in Medicare Advantage...

Small Steps for Accountable Care Organizations to Boost Quality

by Vera Gruessner

While the Medicare Shared Savings Program and the Pioneer Accountable Care Organizations (ACOs) are relatively new programs for the Centers for Medicare & Medicaid Services (CMS), various results show that these models of care have not...

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