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Value-Based Care News

How Maternity Care Home Model Reduces Premature Birth Rate

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The healthcare industry has often found it problematic and costly to manage the health of newborns and mothers of preterm births. There have been social problems among pregnant women that have led to higher rates of preterm births such...

New England, Great Lakes Perform Best at HEDIS Quality Measures

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More than 90 percent of commercial health insurance companies throughout the country adhere to HEDIS quality measures in order to show consumers and surveillance agencies their overall performance with regard to prevention, treatment, and patient...

Is Primary Care the Solution to Value-Based Care Challenges?

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Transitioning to value-based care reimbursement and managing accountable care organizations (ACOs) comes fraught with specific challenges. Both reports from healthcare organizations and interviews with experts who’ve implemented ACOs tend...

CMS Bundled Payment Models Cut $864 for Orthopedic Care Episode

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Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a report encompassing the second annual evaluation of the Bundled Payments for Care Improvement initiative, according to The CMS Blog. This summer, a new proposal was...

How Accountable Care Organizations Meet Quality Benchmarks

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Accountable care organizations (ACOs) are relatively new patient care models that can operate with either public or private health payers. Initially, the Centers for Medicare & Medicaid Services (CMS) created the first accountable care organizations...

Healthcare Bundled Payments Hinder Skilled Nursing Facilities

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How are skilled nursing facilities and other post-acute care centers handling the transition to a value-based care reimbursement environment? Fitch Ratings stated in a press release that many post-acute care providers are finding it difficult...

How Medical Consortium Handles Value-Based Care Reimbursement

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Healthcare organizations around the country have been revamping their strategies to keep revenue stable in the midst of changing healthcare payment models. Reforms have been aimed at helping providers adopt value-based care reimbursement. With...

CMS Accountable Health Communities Model Stresses Social Needs

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This past January, the Centers for Medicare & Medicaid Services (CMS) announced a new funding opportunity for a program called the Accountable Health Communities (AHC) Model, which focuses solely on the social needs of Medicare and Medicaid...

Primary Care, Coordination Drive Accountable Care Organizations

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Within the new value-based care payment strategies being developed among healthcare providers, payers, and government agencies, accountable care organizations (ACOs) continue playing an important role in bringing greater quality improvements...

Medicare Shared Savings Program Saved $466 Million in 2015

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The Centers for Medicare and Medicaid Services (CMS) announced last week the quality and financial results of the 2015 Medicare accountable care organizations. According to a press release from CMS, accountable care organizations operating under...

3 Strategies to Follow in Value-Based Care Reimbursement

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In order to have an effective value-based care reimbursement strategy, healthcare payers and providers will need to implement a number of steps in their pursuit of rewarding quality of care instead of quantity as seen in fee-for-service payment...

Empire BlueCross BlueShield Rewards Strong Care Coordination

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Healthcare payers are often looking for ways to improve care coordination in an effort to enhance patient outcomes and reduce medical spending. Empire BlueCross BlueShield is one healthcare payer that has implemented care coordination measures...

Two Contrasting Opinions on Accountable Care Organizations

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The Patient Protection and Affordable Care Act isn’t merely responsible for creating health insurance exchanges, eliminating pre-existing conditions or even expanding the Medicaid program. The Affordable Care Act also helped build the Medicare...

UnitedHealth’s Value-Based Care Reimbursement Improves Outcomes

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Value-based care reimbursement has been hitting both payers and providers as a surefire way to promote payment reform and reduce medical spending. The new models of payment are coming straight from public payers including the Centers for Medicare...

Why Bundled Payment Programs Could Benefit Mammography Services

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Bundled payment programs have been used in a wide variety of medical treatments and diagnostics such as joint replacement therapy and, more recently, cardiac care. The Centers for Medicare & Medicaid Services (CMS) has established these bundled...

HHS Positions Bundled Payment Models Toward Cardiac Care

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On July 25, the Department of Health & Human Services (HHS) announced further investment in bundled payment models within the healthcare industry. According to a news release from the Centers for Medicare & Medicaid Services (CMS), the...

Affordable Care Act, Accountable Care Display Success

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With fairly large sects of the political spectrum opposing various provisions of the Patient Protection and Affordable Care Act as many as six years after its passage, it grows vital to examine whether or not this landmark healthcare legislation...

How to Educate Employers on Value-Based Care Reimbursement

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Value-based care reimbursement is becoming a mainstay of the healthcare industry as hospitals, physician practices, and health insurance companies continue to incorporate alternative payment models. Many payers and providers have pursued bundled...

Successful Accountable Care Organizations Use 3 Key Strategies

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Health payers and providers who are seeking to form accountable care organizations will need to follow key steps in order to avoid the issues associated with these payment models and truly succeed in an accountable care environment. Below we...

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...

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