Author: Eric Duchinsky

Big Deal or No Deal? Hospital Quality Score Cards Released

The Centers for Medicare & Medicaid Services released the final version of its hospital quality ratings Wednesday and posted them to the Hospital Compare website. Many of the most well-known hospitals in the nation received below average scores while lesser known facilities took the top scores.

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Alternative Payment Models Critical to Healthcare Change

Traditional incentive based payment models are being put phased out. The Centers for Medicare & Medicaid Services (CMS) is now pushing for alternative payment models that focus on quality of care rather than quantity. The CMS hopes to tie 90% of all Medicare payments to alternative payment methods by 2018. To support this transition CMS has proposed changes to the Medicare Access and CHIP Reauthorization Act (MACRA), which focuses on changing the way providers are reimbursed for care.

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Snapshot: Mental Health Crisis Act

The demand for behavioral health services across the continuum of care is high, with 20.1% of adults with a mental illness reporting that they are unable to get the treatment they need. However a major shift in healthcare could be on the horizon. On July 6, 2016, The House of Representatives passed The Helping Families in Mental Health Crisis Act, a bill focused on mental health reform. Many are saying it’s the most significant bill targeting mental health since the 1963¹.

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Mid-Year Update: 4 Major Payer Trends

Q3 is in full swing and now is the time to look at what healthcare trends will bring us into 2017. Many payers are looking at current healthcare trends to help predict changes in the marketplace and isolate places of improvement. From data security to value based payments, it has been a big year for healthcare. Here 4 of the biggest trends payers can expect to hit in Q4 and continue into 2017.

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Provider-Owned Health Plans Make Noise

Provider-owned health plans have been gaining momentum since the roll out of the Affordable Care Act and the impending shift from fee-for-service to value-based payment models. For providers hoping to get a handle on healthcare costs and supplement their own medical data with claims data, launching a health plan has been a strategic move.

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Tips for Shifting to a PCMH Model

Patient Centered Medical Homes (PCMH) value based care model growing across the United States. PCMHs aren’t actually places but care models based on providing care which is accessible, coordinated, and comprehensive. PCMHs focus on patient centered care and are committed to quality and safety.

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CMS Unlocks Claims Data. Now What?

The Centers for Medicare & Medicaid Services (CMS) finalized a new rule that gives providers and employers better access to Medicare and private sector claims data. CMS hopes that the improved access will help organizations make more informed decisions about care delivery and quality improvement.

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Bundled Payments

Payment Models: Taking a Closer Look

The healthcare industry is undergoing an inevitable shift away from fee for service payment models towards reimbursement models that align with the healthcare triple aim, such as value based payments. The approach and question of which value-based model to implement still remains elusive for many organizations. Let’s take a look at some payment types on the value-based reimbursement spectrum.

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See How New ACO Strives For Integration

UnitedHealthcare announced it will be partnering with DeKalb Physician Hospital Organization in Georgia, to launch an accountable care program. The program hopes to improve both patient care and satisfaction through better coordinated care and shared risk.

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