12 Things You Need to Know About Value-Based Reimbursement

Value-Based Health Care is Antithetic to Patient-Centered Care

Public and private payers, including Medicare and some of the nation’s biggest health insurers, plan to hasten the migration of the healthcare reimbursement system from pay-for-volume to pay-for-value. The acceleration in the pace of change from fee for service to risk-based reimbursement is likely to reshape the healthcare business over the next three to five years. While all healthcare stakeholders will be affected, the pioneers of this approach to healthcare financing will be large,
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UCSF, John Muir Health Partner to Form ACO Network

UCSF Sends Data Breach Notification to Nearly 10k Patients 1

UCSF Medical Center and John Muir Health has invested in a collaborative effort, called the Bay Area ACO Network, to form a regional health care network. The goal is to provide the right care at the right time and in the most appropriate setting, whether that is the primary care physician’s office, an outpatient center or a hospital. The two health systems also have formed a new development company that will enable them to collaborate on building new medical facilities, increase the number of
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CMS Unveils Next Generation ACO Model

Meaningful Use Penalties_Meaningful Use_Partial Code Free_Senators Urge CMS to Establish Clear Metrics for ICD-10 Testing

On Tuesday, the Centers for Medicare & Medicaid Services’ Innovation Center (CMS Innovation Center) launched the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery initiative. The next Generation ACO Model will offer a new opportunities in accountable care designed to set predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate care, and attain the highest quality standards of care. Initiative Details The
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Top 4 Population Health Management Challenges

Population Health Management Challenges

As the healthcare delivery model shifts towards value based healthcare, the need for effective population health management solutions continues to grow. However, for many providers choosing the right PHM solution is still uncharted territory and the correct path isn't always clearly marked. According to a recent Chilmark Research report, healthcare organizations are currently struggling with evolving models of reimbursement while PHM vendors have yet to successfully build solutions to fully meet
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Summa Health System and Humana Forms ACO in Akron

Summa Health System and Humana Forms ACO in Akron

  Summa Health System's accountable care organization (ACO) – NewHealth Collaborative and Humana have formed a new ACO agreement to improve health and more coordinated services for the growing number of Humana Medicare Advantage (MA) members in Akron. The new agreement will include value-based incentives tied to performance improvement and will offer more personalized care and a broad range of population management tools like, predictive analytics and chronic care, disease management
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TMA, Blue Cross Offer Physicians ACO Options to Remain Independent

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According to the 2014 TMA Survey of Texas Physicians, approximately two-thirds of Texas physicians work for themselves or in practices that are wholly owned and controlled by other physicians. Most of these independent physicians traditionally have not had access to the tools and resources needed to participate in an ACO. To help address this, the Texas Medical Association (TMA) and Blue Cross and Blue Shield of Texas (BCBSTX) are partnering on a first-of-its kind joint effort to offer
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Cigna Launches Collaborative Care Initiative with Duke Connected Care

Cigna Reaches 100 ACO Goal

Cigna has launched a collaborative care initiative in the Greater Research Triangle with Duke Connected Care, a clinically integrated network consisting of physicians from Duke Medicine and select local practices. The goal of the new initiative is to improve access to health care, enhance care coordination, and achieve the goal of improved health, affordability and customer experience. This program is now one of 10 Cigna collaborative care initiatives in the Carolinas. “A customer-centered
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Kyruus Partners with One of Nation’s Largest ACO Programs

Kyruus

Kyruus, a provider of Patient Access & Referral Management Solutions, announced today that it has partnered with Providence Health & Services, the third largest not-for-profit health system in the United States, to optimize access across its ACO network and provide an improved level of engagement to its consumers across the Northwest. This expanded engagement builds off the successful deployment of ProviderMatch for the Swedish Medical Access Center for the Providence-Swedish Health
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KLAS Rates Deloitte Top Firm for ACO Strategy & Readiness

Deloitte Launches ConvergeHEALTH To Support Value Based Personalized Healthcare

  According to a recent KLAS report, Deloitte has been rated the top firm for ACO strategy development and readiness assessment. The report, ACO Advisory Services 2014: Navigating the Unchartered Territory of Accountable Care, evaluates seven firms based on interviews with 41 health care organizations working to implement value-based care models against three categories: – strategy development - readiness assessment -implementation    Key Highlights The KLAS report gave Deloitte
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Pioneer ACOs Dropout: Why Are Providers Leaving in Droves?

Pioneer ACOs Dropout

What is driving the high Pioneer ACOs dropout rate? Laura Beerman, Director at Decision Resources Group (DRG) explains the key drivers behind the trend. Three years ago, CMS launched the Pioneer ACO program with 32 healthcare organizations designed to work in coordination with private payers by aligning provider incentives, which will improve quality and health outcomes for patients across the ACO, and achieve cost savings for Medicare, employers and patients. Today, only 19 providers
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