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GroupOne Health Source Practice Management Blog

      

The GroupOne Health Source Blog

 Answers and Insights Every Healthcare Professional Needs.

 

CMS Proposes Quality Payment Program Rule for 2018: Here's What You Need to Know

by Kaitlyn Houseman on June 23, 2017

On Tuesday, CMS issued a proposed rule that would make changes in the second year of the Quality Payment Program. The proposed rule includes changes that would not only simplify the program, but also ensure high-quality care within Medicare is at the forefront of the Quality Payment Programs. Here's what you need to know about the proposed rule for the 2018 performance period.

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Topics: Revenue Cycle Management, Practice Management, Merit Based Incentive Payment System, Value-Based Reimbursement, MACRA

CMS Announces New Educational Initiative to Raise Awareness of Chronic Care Management

by Kaitlyn Houseman on March 15, 2017

Today, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) and the Federal Office of Rural Health Policy at the Health Resources and Service Administration (HRSA) introduced Connected Care, an educational initiative to raise awareness of the benefits of chronic care management (CCM) services for Medicare beneficiaries with multiple chronic conditions and to provide health care professionals with support to implement CCM programs.

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Topics: CMS, Value-Based Reimbursement

4 Ways Small Practices Can Best Prepare for Value-Based Care

by Jeff Jones, CPHP on January 3, 2017

When it comes to government regulations and health care, change is inevitable. In contrast to the current fee-for-service care, the value-based care model aims to compensate physicians for high-quality service, clinical performance, and patient satisfaction. It's an exciting time for the future of healthcare, and small practices are uniquely situated to thrive in the transition to value-based care.

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Topics: Revenue Cycle Management, Value-Based Reimbursement, MACRA

MACRA: New Opportunites for Medicare Providers with Alternative Payment Models

by Jeff Jones, CPHP on May 26, 2016

With the repeal of Medicare's sustainable growth rate formula also came the opportunity for physicians to eventually leave the traditional Medicare fee-for-service system behind. The shift from fee-for-service to value based reimbursement is a new opportunity for physicians but with it comes some challenges in understanding how it will work. The final rule, released on Oct. 14th, details how Alternative Payment Models (APM) will enhance or replace some of the current fee-for-service payments with a patient-level payment not related to volume or intensity.

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Topics: Value-Based Reimbursement, Incentive Programs, MACRA, Alternative Payment Models

The Value-Based Payment Modifier Program and It's Impact on Your Practice

by Jeff Jones, CPHP on May 4, 2016

The Value-based Modifier (VBM) provides for differential payments to a physician or group of physicians under the Medicare Physician Fee Schedule and is based upon the quality of care furnished compared to cost during a performance period. The Value Modifier program will provide comparative performance information to physicians as part of Medicare’s effort to improve the quality and efficiency of medical care. Here is how the Value Modifier program relates to PQRS and MIPS to further the movement from fee-for-service to value-based reimbursement.

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Topics: PQRS, Value-Based Reimbursement, Incentive Programs

CMS Launches Comprehensive Primary Care Plus: Value-Based Model for Primary Care Practices, Multiple Insurers

by Kaitlyn Houseman on April 11, 2016

The Centers for Medicare and Medicaid Services on Monday launched a new risk-based primary care initiative that it hopes will accelerate the movement towards value-based reimbursement for medical practices. The five-year, Comprehensive Primary Care Plus, or CPC+, starts in January 2017 and will include up to 5,000 practices and 20,000 physicians in an estimated 20 regions.

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Topics: Value-Based Reimbursement, Incentive Programs

Healthcare Metrics You Need to Track in an Age of Value-Based Payment

by Ricki Ransom on April 5, 2016

The incorporation of value-based payment into healthcare revenue cycle management is one of the defining narratives of this era of healthcare in the United States. The Department of Health and Human Services hopes to shift its payment system to nearly one-third value-based this year, with 50% of its payments to be value-based by the year 2018. Furthermore, it expects nearly all fee-for-service health plans to include some degree of value-based components by then.

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Topics: Revenue Cycle Management, Value-Based Reimbursement