Targeted Care Integration Can Help Drive Success Under Risk Contracts
Providers can avoid many of the missed opportunities associated with risk contracts by carefully reviewing the targeted patient population, narrowing the number of performance metrics, and selecting the right clinicians to participate.
HFMA Trendsetter: Tackling Bundled Payments
This article shares how Premier Inc. helped Adventist Health System successfully navigate bundled payment initiatives by offering a dynamic collaborative led by seasoned experts and user-friendly analytics that enable evidence-based decisions.
Sidebar: Top 10 Most Over-Documented HCCs
Documentation of chronic conditions is increasingly important as hospitals move toward value-based payment models.
Sidebar: Top 10 Most Under-Documented HCCs
Documentation of chronic conditions is increasingly important as hospitals move toward value-based payment models.
CMS Proposal: A Path to an Uncertain Future for 340B
CMS’s proposal to reduce rates for 340B-covered entities for separately payable outpatient drugs may indicate the Trump administration may take an aggressive approach to healthcare policy.
6 Practices for Effective Managed Care Contracting
Certain practices are critical to effective contracts between health plans and provider organizations.
the role of HCCs in a value-based payment system
Documentation of chronic conditions is increasingly important as hospitals move toward value-based payment models.
Charging Appropriately for Emergency Department Visits
To determine a fair charge for an emergency department visit, a hospital or health system must separate its costs into three categories.
Value-Based Payment and Commercial Healthcare Insurers: Getting Paid for Doing What’s Right
Healthcare providers may find that their managed care contracts include provisions that may have been beneficial under a fee-for-service payment model but are highly unfavorable under a value-based payment.
Optimizing Financial Performance Under Value-Based Care
As they seek to adapt their organizations to the demands of value-based care, physician leaders can follow the example of participants in the Oncology Care Model.