Tag Archives: fee-for-value

Three steps: Get ready for risk-based, fee-for-value health care

Ready or not, here it comes — risk-based, fee-for-value health care is here or coming to a market near you! Health care providers are no longer asking whether they should get ready. They are asking: How fast should we make the transition? They know it may not be pretty. “Organizations need to set a goal […]
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Is a provider-led health plan a good fit? Evaluate 6 areas to find out

To drive down costs and improve care through value-based models, one must have a deep understanding of the population they serve. Health care providers have this knowledge. Their familiarity with the demographics, economics and general needs of their communities means some are well-positioned to launch their own provider-sponsored health plans (PSHP) and have a sense […]
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Confirm patients’ medical memories to develop complete health histories

Can you remember what you wore to work last Thursday? How about what you had for lunch yesterday? We humans aren’t particularly great at recalling details. Study after study shows it. Colonoscopy patients don’t remember details of their procedures when more than a year has passed, according to a report in Healio. How about hip […]
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Who should make up the team that directs your move to accountable care?

As the U.S. health care system moves away from reimbursement models that reward volume and toward those that reward care coordination – traditional industry roles are blurring. • New #5in5 video: Fee for value requires revised relationships As this integration accelerates, organizations must build new governance structures that can provide strategic direction and accountability. That […]
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Not perfect, but practice makes progress for ACOs

Recently released results of the Medicare Shared Savings Program (MSSP) highlight the fact that Accountable Care Organizations need to be in it for the long haul. In August, the Centers for Medicare & Medicaid Services issued an update announcing that participating ACOs continue to show improvements in their ability to contain costs. Three hundred and […]
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Understanding a new, mandatory payment model

As the health care industry moves toward population health management, providers and payers are working to determine which value-based reimbursement models show the most promise. The Centers for Medicare and Medicaid Services gave the bundled payments a boost this year by making the model mandatory for a number of hospitals — first for hip and […]
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Roadmap to partnership: Keys to identifying the best revenue cycle partner for you

After careful scrutiny of productivity, processes and technology costs, many CFOs see the value in partnering with an external company that can take over day-to-day revenue cycle operations. Such a partner is built for revenue cycle management (RCM) and can likely do it better than most hospitals or health systems. For CFOs, it may make […]
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Roadmap to partnership: Assessing your current revenue cycle operations

Fee-for-service reimbursement is pretty cut-and-dried for revenue cycle managers. Profits revolve around billing, collecting from insurers and resolving patient claims on an individual basis. That’s not the case under fee-for-value models, where insurers capitate reimbursement for certain populations — a scenario that has revenue cycle management (RCM) leaders scrambling for ways to handle changes in […]
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Part 3: Thriving in a regulated era — achieving go-to-market strategies

The final entry in our “Thriving in a regulated era” blog series concludes with the technology road map, sourcing strategies and go-to-market guidance. Our first two blogs in this series touched on developing the business vision, business plan and capabilities model. Follow the technology road map. While the business plan drives your entry into new […]
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Preparing your organization for value-based care

Being prepared is sound strategy in all areas of life. The Boy Scouts live by it. Homeowners in hurricane zones stay ready for the worst. And health care executives know it’s the secret to longevity in the helter-skelter world in which they operate. Preparation is even more important now that value-based reimbursement is building momentum. […]
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