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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.”
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.
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.
Learn what action steps hospitals should consider in preparing for RAC extrapolation.
The proposed Medicare Shared Savings rule makes ACOs more tangible for providers, but it also contains a few surprises.
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.
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.
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.
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.
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.
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.
New flu, obesity V codes are among the ICD-9-CM changes for FY11.
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.
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.
In what seems to have become an annual exercise in fiscal futility, the Medicare trustees dutifully released their annual report in late March indicating impending fiscal disaster for Medicare.
Productivity improvement can help healthcare organizations achieve significant efficiencies and cost savings. What CFO wouldn't like those results?
Amy Amick, president, revenue cycle management, and William Davis, vice president, revenue cycle advisory solutions, both with MedAssets, share insights on the industry and techniques to drive sustainable performance improvement.
Eric Ward, president and CEO, Parallon Revenue Cycle Services, discusses key trends in revenue cycle management and factors providers should consider when partnering to advance their revenue cycle performance.
Doug Festermaker, managing partner and executive vice president of health care, Warbird Consulting Partners, shares strategies to leverage outsourced CFO expertise to lead special projects or fill interim roles while recruiting is underway.
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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