On Monday, CMS Secretary Alex M. Azar II announced the launch of CMS Primary Cares—an initiative with two sets of new payment models that will enroll a quarter or more of traditional Medicare beneficiaries and a quarter of providers in arrangements that pay for keeping patients healthy, rather than ordering procedures.New Primary Care Payment Models1. The Primary Care First path will allow smaller primary care practices to be paid a simple, flat stream of revenue for each patient. When a patient
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Healthcare Policy Regulation & Reform | News, Analysis, Insights - HIT Consultant
4 Major In-Home Healthcare Market Drivers to Watch
We are seeing a perfect storm in the making in healthcare with trends that have combined to form tailwinds that are now poised to drive massive expansion in the home healthcare market.
Even in the fast-growing healthcare sector, the home health industry stands out for its explosive growth. Home health spending is expected increase at a faster rate through 2027 than all other categories of care, according to a recent analysis from the Centers for Medicare & Medicaid Services (CMS) Office
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AllyAlign Health Raises $10M to Power Value-Based Care for Seniors
AllyAlign Health, a Richmond-based developer and administrator of Medicare Advantage special need plans that benefit long-term care providers has raised $10M in strategic funding led by McKesson Ventures. Existing investors Heritage Healthcare Innovation Fund, Health Enterprise Partners and the LinkAge Fund also participated in the financing. This brings the total capital raised to over $41 million.AllyAlign Health BackgroundAllyAlign Health (AAH) began reforming the health system in 2014 by
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Value-based Care in America: A Table View of State-by-State Initiatives
Value-based care programs are flourishing across the U.S., with a seven-fold increase in the number of states implementing such initiatives in the past five years, according to a new Change Healthcare report. The report, Value-Based Care in America: State-by-State is the second national study of state healthcare payment programs that reveal 48 states have now implemented value-based care or payment programs, 50% of those programs are multi-payer in scope, and just four states have little or no
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Cerner, naviHealth to Launch Medicare BPCI Advanced Offering
Cerner and naviHealth, a provider of post-acute management has announced an expanded relationship with plans to create a new offering for the Medicare’s Bundled Payments for Care Improvement Advanced program (BPCI Advanced). After working together for five years to streamline electronic workflows for post-acute discharge, Cerner and naviHealth anticipate launching the new value-based care offering to support BPCI Advanced, with an initial focus on the next CMS launch of the program in January
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UnitedHealthcare Expands Bundled Payments with Medicare Advantage Plans
UnitedHealthcare announced this week it is expanding its use of bundled payment offerings to care providers participating in Medicare Advantage plan networks across more than 30 states to improve quality and lower costs. The expansion builds upon UnitedHealthcare’s existing work with the Centers for Medicare & Medicaid Services’ Bundled Payments for Care Improvement Advanced (BPCI Advanced) program for fee-for-service Medicare.UnitedHealthcare Care Bundles Program OverviewThe
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U.S. Healthcare Spending Reaches $420M Per Hour, On Track to Hit $12 Trillion by 2040
The United States currently spends more than $420 million per hour on healthcare, a number that is increasing by the minute and is expected to top $12 trillion in 2040, according to HealthCostCrisis.org, a new, interactive website and crisis clock that tracks and forecasts healthcare spending in America in real time. The site, developed by West Health, a family of nonprofit and nonpartisan organizations includes tools to gauge the impact of the escalating cost of healthcare on patients and
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AHIMA, AHCA Partner to Train Skilled Nursing Facilities in ICD-10 Coding to Prepare for New Patient Driven Payment Model
The American Health Information Management Association (AHIMA) has announced a collaboration with the American Health Care Association (AHCA) to provide in-depth coding and clinical documentation improvement (CDI) training programs. The goal of the collaboration is to help professionals in skilled nursing facilities (SNF) prepare for the upcoming payment reimbursement change.New, Value-based Patient Driven Payment Model (PDPM) Beginning October 1, 2019, the Centers for Medicare and Medicaid
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Blue Cross NC, Duke Health Form New Company to Offer Medicare Advantage Plan for Seniors
Blue Cross and Blue Shield of North Carolina and Duke University Health System have together formed Experience Health, a new health insurance company to offer a Medicare Advantage Plan in 2020. Jointly owned by Blue Cross NC and Duke Health, Experience Health brings together two of the most trusted and innovative names in healthcare to create a locally owned and operated non-profit health plan.Why Experience Health?Blue Cross NC and Duke Health formed Experience Health to take advantage of the
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AMA, UnitedHealthcare Develop ICD-10 Codes to Support Social Determinants of Health
UnitedHealthcare and the American Medical Association (AMA) are teaming up to support using data for social determinants of health (SDOH) to improve and simplify how referrals are made to social services. The collaboration builds off work initiated by UnitedHealthcare to standardize how data is collected, processed and integrated regarding critical social and environmental factors that contribute to patient well-being.
New ICD-10 related to Social Determinants of Health (SDOH)
Today, nearly 80%
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