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The long and winding road toward accountable care has not been without bumps, but accountable care organizations constitute a bona fide, inexorable trend that should pick up steam in the years ahead.
The Medicare value-based purchasing (VBP) program is an initiative described in the Affordable Care Act whose purpose is to provide a practical means to reduce costs to the nation’s healthcare system while improving quality of care. Hospitals that achieve the highest total performance scores (TPSs) under this program’s scoring methodology can earn incentive payments for performance excellence.
One study suggests that success under the Medicare value-based purchasing program may correlate with higher expenditures on routine services that impact patient satisfaction.
CMS is renewing efforts by its contractors to enforce compliance with signature guidelines.
The Centers for Medicare & Medicaid Services list of hospital acquired conditions for FY10.
One organization’s long experience as an accountable care organization shows that accountable care can be successful, not only in improving population health, but also financially.
The July 2011 report by the CMS actuaries contains good news and bad news—depending on one’s perspective.
If Congress decides to retain an RBRVS type payment system, it will need to consider whether it wants to modify the SGR in some way rather than remove it entirely.
The Issue The Medicare value based purchasing program is an initiative described in the Affordable Care Act whose purpose is to provide a practical means to reduce costs to the nation’s healthcare system while improving quality of care.
Brent James, MD, chief quality officer at Intermountain Healthcare, says using data-driven performance improvement grounded in shared values is “just good management.”
New flu, obesity V codes are among the ICD-9-CM changes for FY11.
The average cost per discharge was $9,100 for all payers in 2008. Medicare discharges had the highest average cost per hospital stay ($11,300).
Hospital revenue cycle leaders should prepare for the expansion of the RAC program to include review of Medicaid claims.
The Conditions of Participation for Critical Access Hospitals have specific requirements that bear careful, periodic review to ensure ongoing compliance.
The Medicare Shared Savings Program has created the impetus for accountable care organizations. But financial leaders should heed two important lessons from past integration efforts-and six influential forces-before pursuing an accountable care organization.
CMS has an active to-do list under the Affordable Care Act (ACA) for implementing its “Pay for Quality” strategy.
Recent pressures from the Medicare RACs and various third-party payers have increased the sense of urgency that hospital leaders feel about getting observation programs established.
The HHS Office of Inspector General is focusing on readmissions. Hospitals that have excessive readmissions may see reduced payments under the Hospital Readmissions Reduction Program.
Medicare-Medicaid enrollees account for a disproportionately large share of expenditures in both programs, totaling approximately $120 billion in federal and state spending.
A well-written RAC appeal letter can help you win your case and ease the administrative burden of audits.
Providers may be affected by the retroactive increases in payment rates for claims affected by the Affordable Care Act and 2010 Medicare Physician Fee Schedule changes.
Learn what action steps hospitals should consider in preparing for RAC extrapolation.
Glenn Hackbarth, chairman of the Medicare Payment Advisory Commission, shares his thoughts about the cost-effectiveness of preventive care initiatives and other issues related to Medicare.
Restoration-or reengineering? With its 2004 changes to the inpatient rehabilitation classification, CMS rocked the rehab world, and the impact is still being felt today.
All those wanting to be part of the Medicare payment by episode demonstration (aka bundled payment), come on down! And bring your data and signatures.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
Scott Schmidt, vice president, Cerner RevWorks, LLC, shares insights on best practices for maximizing a revenue cycle management partnership.
Dale Hockel, senior vice president of operations, and Jim Fanelli, CFO, TriMedx, share strategies for elevating clinical engineering through innovative management programs.
Rick Heise, senior vice president, revenue cycle, at Cerner Corporation, discusses the importance of integrating clinical and financial data to excel in health care's changing payment environment.
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