Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Value-Based Care News

Payers Continue Favoring Accountable Care Organizations

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As the health payer industry and the Centers for Medicare & Medicaid Services (CMS) continues to invest in value-based care reimbursement and tie payment to quality performance measurement, the benefits of accountable care organizations continues...

How Risk-based Bundled Payment Arrangements Boost Quality

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Bundled payment arrangements are slowly being recognized by providers and payers as methods for reaching the Triple Aim – quality care improvements, lower costs, and better health outcomes. Some consulting companies are even educating their...

Hospitals Lagging Behind in Population Health Management

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As most health payers know, population health management and value-based care payments go hand-in-hand. When it comes to effective population health management, data storage and analysis plays an integral role among payers and providers. As payers...

Payers and CMS Seek to Join Accountable Care Organizations

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Healthcare payers seeking to reduce costs of medical services would benefit from partnering with accountable care organizations, which essentially seek high quality care in value-based payment arrangements. With a stronger focus on population...

Bundled Payment Model, Lump Sum Insurance Plans Make Headway

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As the healthcare industry especially the medical insurance space continues to seek methods for reducing ever-increasing costs, the bundled payment model shows more promise for payers and providers alike. The Centers for Medicare & Medicaid...

CMS Released Proposed Rule for Accountable Care Organizations

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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 Program....

Physician Leadership Key to Accountable Care Organizations

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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 organizations to...

CMS Includes Rich History of Healthcare Bundled Payments

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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 Replacement...

How ACO Providers Could Integrate Specialty Care with PCPs

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Healthcare providers and payers working together to develop an effective accountable care organization (ACO) and a strong contract will need to consider the importance of including specialty care, an article from the Health Affairs publication...

CMS Published Final Rule for Surgical Bundled Payment Model

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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 costs...

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

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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 the ACO...

CMS Announced 121 New Accountable Care Organizations

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On Monday, the Centers for Medicare & Medicaid Services (CMS) revealed that there will be 121 new accountable care organizations joining the ranks of Medicare ACOs and the Shared Savings Program. A press release from the Department of Health...

Top Challenges of Alternative Payment Models, Bundled Payments

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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 take...

Population Health, Risk-sharing Vital for Accountable Care

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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 Shared...

Why are Bundled Payment Systems Difficult to Adopt?

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While bundled payment systems have been advocated as a means to reduce the costs of medical care by the Centers for Medicare & Medicaid Services (CMS), many health insurers and providers are still stuck on fee-for-service payment models....

Small Steps for Accountable Care Organizations to Boost Quality

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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 brought...

Top 4 Factors Necessary for Bundled Payment Model Contract

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In today’s healthcare climate, payers are working to develop value-based reimbursement contracts with their provider network. Lately, payer and provider contract negotiations are often based around alternative payment methods such as the...

How to Design and Support an Accountable Care Organization

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When a large establishment wants to bring more care coordination and greater organization among multiple medical facilities including primary care offices, hospitals, and specialty entities, there are specific steps to take and certain aspects...

75% of Providers Drop Out of CMS Bundled Payments Model

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The Innovation Center belonging to the Centers for Medicare & Medicaid Services (CMS) created the Bundled Payments for Care Improvement (BPCI) program, which consists of setting aside a previously agreed-upon set of funds for several healthcare...

Why Health IT is Critical for an Accountable Care Organization

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In order to provide medical services under an Accountable Care Organization (ACO), a network of medical practices, specialty healthcare offices, and hospitals must contract with a health payer such as Medicare, Medicaid, commercial health plans,...

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