A Blueprint for Building a ‘Risk Ready’ Healthcare Organization
The cornerstone capabilities healthcare providers require for success under risk contracts are contract modeling and negotiation, care management and coordination, analytics and technology, and relationships and alignment.
Preparing for BPCI-A: Avoiding the Common Mistakes Providers Make when Implementing New Payment Models
The primary goal for healthcare providers participating in Bundled Payments for Care Improvement Advanced (BPCI-A) should be to master the competencies associated with becoming a high-value provider.
Beyond the Rhetoric: Implications and Unintended Consequences of Tax Reform and Medicare Policy
Tax reform and changes in federal healthcare policy could have the unintended effect of exacerbating the challenges U.S. hospital face in contending with uncompensated care.
Where Providers Are Finding Value-Based Profit
Healthcare provider organizations that are seeking ways to successfully accomplish the shift from fee-for-service to value-based payment can gain insight from the experiences of provider organizations that are industry leaders in this transition.
Administration Meets Challenge to Risk-Adjustment Payments, Counter to Critics’ Assumptions
Responding to a New Mexico district court’s ruling against the risk-adjustment program established by the Affordable Care Act, CMS initially put the program’s payments to collections and payment on hold, but then took steps to reinstate the program.
4 Steps for Success in a Changing Payment Landscape
The experiences of oncology practices participating in CMMI’s Oncology Care Model offer insight on how physician practices can best adapt their revenue cycle for value-based payment models.
Ask the Experts: Bundled Payment Start Date and Allocation
What parameters have other hospitals used to set a start date for moving to a bundled payment versus fee-for-service?
Understanding Pricing Trends in a Changing Environment
Pricing data can help providers make more informed strategic decisions and build better relationships with their patients.
A Push to Streamline Value-Based Payment
Value-based payment is ripe to repeat past fee-for-service problems—widespread slowdowns as each entity took different approaches to data collection and sharing and, as a result, hampering interactions. CAQH CORE is getting in front of these challenges now.
How to Get Involved in CAQH CORE’s Work
CAQH CORE currently is forming groups to work on healthcare data standardization. Healthcare finance professionals are a core constituent and CAQH welcomes their participation.