Blue Cross and Blue Shield of Illinois (BCBSIL) has signed an agreement to launch an innovative new value-based care model with DuPage Medical Group (DMG), the largest independent physician practice in the Chicago area, with more than 425 doctors. Traditionally in a fee-for-service delivery model, reimbursement is based on specific services provided to patients; rewarding providers for the volume of services they provide. In value-based care, payment to providers is associated with meeting
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Healthcare Policy Regulation & Reform | News, Analysis, Insights - HIT Consultant
WEDI ICD-10 Survey Reveals Physician Practices Lagging Behind
While much of the industry is getting closer to ICD-10 readiness, only about 20 percent of physician practices have started or completed external testing and less than 50 percent responded that they were ready or would be ready for Oct. 1, according to recent Workgroup for Electronic Data Interchange (WEDI) industry preparedness survey results. In a letter sent to the Health and Human Services (HHS) Secretary, WEDI shared findings from its June 2015 ICD-10 Industry Readiness Survey, strongly
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Report: Multimedia Patient Engagement Programs Increases HCAHPS Scores
Emmi Solutions, a provider of outcomes-driven patient engagement, analyzed nearly 100,000 HCAHPS surveys from multiple service lines in 29 hospitals across the country and demonstrated that patients who viewed one of the company’s web-based, interactive programs reported higher patient satisfaction scores when compared with patients who had not. Patient satisfaction scores have always been important to providers but now that the Centers for Medicare & Medicaid Services (CMS) are tying
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5 Elements of Successful Patient Engagement
In recent years, there has been a great deal of discussion about how to engage patients in their care. Patient engagement has always been considered a good thing in practices and health care organizations. Today it is vital to the business of delivering care. Why the shift? Patient engagement is an essential strategy for achieving the “triple aim” of health care:
• Improving the patient experience. Patients are expecting and demanding greater control over their care. Provisions in the
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5 Lessons the US Can Learn from Canada’s ICD-10 Transition
Like it or not, the clock is ticking down to ICD-10 transition. Despite physician angst and political pushback, ICD-10 coding will soon be underway. While the uncertainty of any grace-periods for providers remain, the question persists: Will October 1, 2015 be a day of progress for U.S healthcare or its day of reckoning?
According to the CDC, the new coding system that promises to improve data quality and streamline reimbursements will have nearly 19 times the procedural codes and five times
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CMS, AMA Partner to Help Providers Get Ready For ICD-10
With less than three months remaining until the ICD-10 transition, The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) are announcing efforts to continue to help physicians get ready ahead of the October 1 deadline. In response to requests from the provider community, CMS is releasing additional guidance that will allow for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD- 10
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Aetna to Buy Humana for $37B, Largest Insurance Deal Ever
Health care-insurance giant Aetna has agreed to acquire smaller rival Humana for $37 billion in cash and stock making it the largest ever deal in the insurance industry. The rapid consolidation in the U.S. health care industry. brings together Humana’s growing Medicare Advantage business with Aetna’s diversified portfolio and commercial capabilities to create a company serving the most seniors in the Medicare Advantage program and the second-largest managed care company in the nation.
Under
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Why Non-Specific ICD-10 Codes Are a Non-Issue
A safe harbor or grace period that would allow the submission of “less specific” ICD-10 codes after the ICD-10 transition continues to be raised as a way to alleviate the burden of the transition on physicians. For example, HR 2247, the ICD-TEN Act, would prohibit Medicare from denying claims “due solely to the use of an unspecified or inaccurate subcode.” A letter to the Centers for Medicare & Medicaid Services (CMS) from several members of Congress recommends that CMS indicate “whether
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Florida’s PremierMD ACO Selects eClinicalWorks for Population Health Management
Florida’s PremierMD ACO LLC (Premier), an ACO participating in the Medicare Shared Savings Program, has chosen the eClinicalWorks CCMR population health platform to advance its ACO objectives, coordinate care across the continuum as well as evaluate population health and quality improvement activities. eClinicalWorks will also be the preferred EHR solution for the organization.
Premier participates in the Medicare Shared Savings Program, which has been created by the Centers for Medicare
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King v. Burwell: 5 Key Trends Driving Consumer-Focused New Health Economy
Today, the Supreme Court affirmed the 4th Circuit, holding that tax credits are available in states using the federal exchange. PwC's Health Research Institute (HRI) performed an analysis of publicly available information - including ACA enrollment data and CMS data on hospital spending - to assess the financial impact of the loss of subsidies in the federal marketplace. The Court’s decision in King v. Burwell removes uncertainty for some 8 million Americans who were at risk of losing coverage
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