Tag: Accountable Care Organizations

CPT® codes play a pivotal role in the transition to value-based care

In order for value-based healthcare to succeed, it is imperative that physician practices effectively articulate the medical services and procedures they provide. This underscores the vital role of the Current Procedural Terminology (CPT®) code set in driving the shift towards value-based care. According to the chair of the AMA/Specialty Society Relative Value Scale Update Committee (RUC), […]
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Increased-Data-Transparency-Results-Higher-Compliance

Increased Data Transparency Results In Higher Compliance

One Medicare Advantage plan used the Ribbon tool to focus on quality measures and saw a 342% net increase in users achieving a 4+ star rating. Increased data transparency between health plans and providers on care and coding gaps results in higher compliance, process improvement and positive behavior changes among network providers, according to a […]
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Value-Based-Payment-Models-Can-Limit-Healthcare-Spending

Value-Based Payment Models Can Limit Healthcare Spending

Value-based payment models, including accountable care organizations, bundled payment models, and capitation models, can generate savings for providers and limit healthcare spending. As healthcare spending escalates in the US, stakeholders have started looking at value-based payment models to address rising costs, but many payments are still tied to fee-for-service models, according to a Health Affairs […]
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AHIP, Other Stakeholders Support Medicare Value-Based Care Bill

Medicare value-based care efforts are crucial for moving forward value-based care in the healthcare industry overall. In a joint letter to the four representatives who introduced the bill in the House of Representatives, payer and provider organizations have thrown their support behind the Value in Health Care Act of 2021 which seeks to bolster Medicare […]
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Rethink ACO Financial Risk Advancement in MSSP

AMGA expressed some concerns following CMS’ decision to extend its postponement policy regarding ACO financial risk advancement in the Medicare Shared Savings Program. The American Medical Group Association (AMGA) recommended several steps regarding accountable care organization (ACO) financial risk advancement in the Medicare Shared Savings Program (MSSP) in a letter to CMS. CMS’ decision to […]
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