Tag Archives: healthcare industry

Do bundled payments encourage more procedures? New study offers answer

New research aims to determine whether a claim that bundled payments may actually increase costs rather than control them holds any weight. Becker’s Hospital Review and McKnight’s reported on the study from the Centers for Medicare and Medicaid Services and the Altarum Institute. At issue was whether bundled payments — also known as episode-based payments […]
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Identify the linchpin to cultural change

There are hurdles that make implementing an analytics platform a unique challenge. But at its core the job is really one of change management. The linchpin to any cultural change is clinical and administrative leadership. Dr. Lewis Sandy, senior vice president of clinical advancement for UnitedHealth Group, says leadership is probably the most difficult requirement […]
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Monitor these metrics to find revenue leaks

Tracking, explaining and plugging gaps in your revenue cycle is tough enough without the added challenge of practice acquisitions and mergers. Joining two systems means standardizing and streamlining policies that may differ greatly from each other. As consolidation work takes place, health systems can pay close attention to certain metrics to help identify revenue leaks. […]
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Addressing the possible effects of overlapping reimbursement models

At the core of bundled payments is the goal of improving coordination between all of the facilities and agencies a patient might visit or employ during one episode of care. But as health care providers adjust to this new reimbursement model, some are experiencing trouble coordinating bundled payments with other value-based care initiatives. In the […]
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Understanding the risks of incomplete medical coding

Information that could affect readmission risks, reimbursement, quality assessments and more is missing from medical records according to a recent study. MedPageToday reported on the study, conducted by researchers at Johns Hopkins University School of Medicine and published in November 2015 in the journal PLOS ONE. The researchers compared two large databases – one based on claims […]
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Health systems: Do you see payers as partners or adversaries?

“It’s not the fact that we did that, it’s how we did it.” That’s what Jeff James, chief executive officer for Wilmington Health says is the headline from his group’s decision to team with Blue Cross/Blue Shield of North Carolina to create that state’s first commercial accountable care organization (ACO).  Watch Jeff James answer 5 […]
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Linking quality data to risk-based contracting success

What you don’t know might hurt you. That seems to be the fear plaguing health care executives eyeing a transition to contracts that put providers on the hook for financial risk. Healthcare Informatics (HCI) reported on a survey from trade association American Medical Group Association (AMGA). It asked health care executives about the biggest barriers […]
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5 -priorities for groups pursuing a risk-based strategy

When you’re used to being paid based on a tally of procedures, it can be daunting to consider taking on the financial responsibility for outcomes. Where do you start? Or if you are already bearing some risk, how do you prepare to accept more? Organizations pursuing a risk-based strategy need to address five key areas […]
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Timing a transition to value-based care

Once providers decide they will transition to value-based care, the next question is when should they make their move. Providers can do more than pick an arbitrary date. There are tools to help organizations make informed decisions on transition timing. Providers can conduct a financial impact assessment. Doing so allows groups to model several factors […]
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Health system id’s source of new ideas for reform

Proponents of Lean process improvements can’t seem to emphasize enough the importance of engaging all employees and empowering them to become problem solvers. Books, academic reports and articles all address the issue. Their message? Good ideas can come from anywhere – from a newly hired housekeeper to a ready-to-retire nurse manager. The CEO of a […]
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