Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Value-Based Care News

Blue Shield, Accountable Care Organization Saved $325 Million

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In recent years, there has been plenty of concern about whether or not Accountable Care Organizations (ACOs) bring significant cost savings to the healthcare industry. However, one health payer and ACO have proven that it is possible to make...

Value-based Payment Models Pose Challenge to Physicians

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In HealthEdge’s State of the Payer Industry Survey, more than 80 percent of polled health payers are planning to support value-based payment models over the next three years. Additionally, nearly 77 percent of health plans are looking to...

Altering Accountable Care Organizations May Bring More Success

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Despite the fact that Accountable Care Organizations (ACOs) and the Medicare Shared Savings Program was supposed to put a dent in the rising healthcare costs around the country, the latest results show that both in 2013 and 2014, only about 25...

HIT Boosts Population Health Data Analysis, Patient Outcomes

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When healthcare providers join together to form an Accountable Care Organization, a major goal of theirs is to improve the health of their given population. But what are some key areas where ACOs and payers could analyze population health data...

Population Health Management Achieved through Accountable Care

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Population health management is a complex area within the healthcare industry that has received a much bigger spotlight in recent years. In particular, after the Patient Protection and Affordable Care Act became law, Accountable Care Organizations...

Why Value-based Care Needs Clinical Decision Support Tools

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Ever since new legislation such as the Affordable Care Act or the Health Information Technology for Economic and Clinical Health (HITECH) Act were passed, the healthcare industry has been reforming and moving toward value-based care. There are...

Challenges, Advantages of Merit-Based Incentive Payment System

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The Merit-Based Incentive Payment System (MIPS) is a new reimbursement program used by the Centers for Medicare & Medicaid Services (CMS) that has its own unique set of challenges and advantages for provider payment. Earlier this year, the...

Top 3 Ways to Meet HEDIS Quality Measures, Improve Performance

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The entire healthcare industry benefits greatly from the quality measurement programs including the Healthcare Effectiveness Data and Information Set (HEDIS) tools developed by the National Committee for Quality Assurance (NCQA). The HEDIS quality...

How Consumer Engagement Brings Better Coverage Decision-Making

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Consumer engagement and awareness is key when payers aim to raise their enrollment rates before the enrollment period rolls around. First, it is vital to improve the health literacy of the everyday consumer so that these individuals understand...

Why Population Health Data is Integral for Value-based Care

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The study of population health data could be relevant for both payers and providers, as it could affect reimbursement for healthcare services. As hospitals and clinics continue to promote wellness programs, improve patient safety, and reduce...

How to Create a Useful Contract for Bundled Payment System

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In 2013, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced that 450 medical providers will take part in a Bundled Payments for Care Improvement initiative. However, more recent results show that healthcare providers...

The Role ACOs Play in Propelling Population Health Management

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Patient and family engagement, care coordination, data analytics, and population health management are all major goals when designing and adopting an Accountable Care Organization. The Commonwealth Fund outlines three different cases of developing...

Top 3 Ways to Reduce Healthcare Spending Across Industry

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What new innovations and healthcare reforms are making a real benefit to cutting unnecessary healthcare spending associated with duplicative tests, hospital-acquired infections, and medical errors? While there are a wide number of transformations...

Maryland’s All-Payer Model Shows Promising First Year Results

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Last week, the Department of Health and Human Services (HHS) announced the state of Maryland’s first year results from its All-Payer Model. Maryland has implemented a global budget payment system in which insurers are required to pay hospitals...

Accountable Care May Bring Savings in Healthcare Costs

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Healthcare reforms have been on the rise due to new federal regulations including the stipulations of the Patient Protection and Affordable Care Act as well as the Health Information Technology for Economic and Clinical Health (HITECH) Act....

How the Bundled Payment System Supports Coordinated Care

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The bundled payment system offers a method for reducing skyrocketing costs throughout the healthcare delivery continuum by moving away from fee-for-service reimbursement. In particular, the bundled payment system covers all of the costs associated...

Medicare Shared Savings Program Seeks High ACO Performance

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As part of the Patient Protection and Affordable Care Act, goals of improving the quality of healthcare services and reducing costs led to the creation of Accountable Care Organizations (ACOs) and the Medicare Shared Savings Program. Both quality...

How MACRA Affects Future of Healthcare Payment Models

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Earlier this year, the federal government repealed the Medicare Sustainable Growth Rate (SGR) Formula, which affected the future of healthcare payment models all across the board. Recently, the Centers for Medicare & Medicaid Services (CMS)...

The Monetary Outcomes of the Accountable Care Organization

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Now that the Affordable Care Act has been in place for five years, there is more evidence showing its overall impact on the healthcare industry. For instance, medical experts, stakeholders, and the patient community have a better understanding...

Accountable Care Organizations, Technology Cut Medical Costs

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The healthcare system has a multitude of gaps that cause spending to continue rising without an effective method to reign in these high costs. For example, a major problem has been ongoing redundant tests and unnecessary, expensive procedures...

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