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For Value Based Healthcare Choices

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Protected Health Information (PHI)

How Compliance Relates To PHI (Protected Health Information) In an Office Setting

By

Rick Grizzle

|

July 17, 2018

And there are several of the most common violations for this. There's a list of them. And most offices don't realize that they may be out of compliance...

Fee For Service

Capitation vs. Fee-for-Service

By

Scott Hodgin

|

July 30, 2018

As the current U.S. healthcare environment trends toward value-based care, the fee-for-service (FFS) reimbursement model is under intense scrutiny, often labeled as an antiquated payment model that promotes over-utilization by physicians and patients, while creating fragmentation among healthcare service...

accountable-care-organization

ACOs vs HMOs: Here’s How They’re Different

By

Scott Hodgin

|

March 19, 2018

Health systems and managed health care are inventions of the early 20th century, but it wasn’t until the early 1970s that Health Maintenance Organizations (HMOs) were defined as such and considered solutions for dangerously high healthcare costs. Although prevalent throughout the 1980s and 90s, HMOs for various reasons...

accountable-care-organization

What Is North Texas CIN (TXCIN) ?

By

|

March 27, 2018

Hey, everybody, my name is Ben Gazaway, I serve as the Chief Operating Officer for North Texas Clinically Integrated Network, or TXCIN. Wanna say welcome, we're excited to have you as part of our network, we've got a lot of exciting things going on here. Today is the first. This is the first of several videos that we're gonna be putting out that details some exciting things that are going on in the network, as well as industry news in and around the country, so hope you'll tune in for those. Our mission at TXCIN is simple. We're here to...

accountable-care-organization

Diabetes and Accountable Care Organizations: A Value-based Care Strategy

By

Scott Hodgin

|

March 19, 2018

In today’s healthcare system, diabetes, and treatment associated with the disease, continues to be a major contributor to rising healthcare costs. Diabetes remains the 7th leading cause of death in the United States, affecting 30.3 million Americans in 2015, or 9.4% of the U.S. population. In 2012 the total cost of diagnosed diabetes, and prediabetes, in the U.S. was $322 billion. Experts agree that in order to lower the...

accountable-care-organization

The HMO Act of 1973: Objectives Finally Met through ACOs?

By

Scott Hodgin

|

April 24, 2018

Signed into law by President Richard M. Nixon on December 29th, the HMO Act of 1973 was ambitious legislation that initiated a long, bumpy, and unsatisfying endeavor to establish a comprehensive healthcare delivery system that lowered medical costs and provided quality care to every American. Senator Edward M. Kennedy favorably described the proposed legislation as “a drastic overhaul of [the] entire way of doing business in the healthcare field” (Brase). The legislation obligated the Federal Government to support the...

Medicare Shared Savings Program (MSSP)

The Medicare Shared Savings Program: Risk vs Reward

By

Scott Hodgin

|

April 2, 2018

The Medicare Shared Savings Program (MSSP) was created by the Centers for Medicare and Medicaid Services (CMS) as part of the Affordable Care Act (ACA) of 2010. Launched in 2013, the MSSP is CMS’s largest Accountable Care Organization (ACO) program, covering 10.5 million assigned Medicare beneficiaries in 2018. The MSSP is the key component in Medicare payment reform, utilizing ACO models to lead the transformation from fee-for-service (FFS) to value-based health care. It’s no secret that...

Shared Savings

How Quality Affects Shared Savings

By

Scott Hodgin

|

March 5, 2018

The Medicare Shared Savings Program (MSSP), or Shared Savings Program, was created by the Centers for Medicare and Medicaid Services (CMS) as part of the Affordable Care Act (ACA) of 2010. Launched in 2012, the MSSP has become a key component in Medicare delivery payment reform, utilizing Accountable Care Organizations (ACOs) to lead the transformation from fee-for-service (FFS) to value-based health care. Now in its sixth year, the MSSP has grown...

Fee For Service

Fee-for-Service Health Care: Three Phenomenon Affecting Success

By

Scott Hodgin

|

April 19, 2018

The United States healthcare system is experiencing a major shift in delivery and payment policy to address out-of-control spending and low-quality care. In 2010, the Affordable Care Act (ACA) set in motion a new vision for healthcare delivery and reimbursement—value-based care—aimed at replacing the “broken” traditional fee-for-service (FFS) model. Massive change takes time, yet lawmakers and industry experts are determined to fully replace the..

Value Based

Quality Over Quantity: What Value-based Care Means for Providers

By

Scott Hodgin

|

March 5, 2018

The age of value-based healthcare is here, and the Centers for Medicare and Medicaid Services (CMS) has taken the lead in healthcare delivery and reimbursement reform. The strategy is driven by a three-part aim to offer better quality health, to improve patient healthcare experiences, and to deliver services at lower costs. CMS has designed an array of care programs and payment models that are meant to shift the focus of healthcare from volume-based care to value-based care, to change the mindset of providers in today’s healthcare system to focus on quality over quantity. However, this change is not a “light switch” type of adjustment, where providers can...

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Dr. John Moore, of Dr. John Moore ENT, discusses the benefits of using revelationMD's mpactMD physician-centered data bridge to get transparent insight into provider costs and quality-- so he can make the best real-time decisions for his patients.

popular quotes
"It was evident that self-insured employers, health plans, third party administrators, and carriers needed to collaborate directly and strategically with physicians and their supporting provider ecosystems if they really wanted to reduce healthcare costs." - Quote from How Physician Collaboration Drives Value
"This shift in healthcare strategy is extremely beneficial to the patient population, because it delivers a connected care experience where patients receive more coordinated, appropriate, and effective care, improving the health of individuals and their communities." - Quote from How Value Based Care Differs From Traditional Care
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popular quotes
"When the physicians are successful at improving outcomes that relate to high-impact portions of a population, the cost of caring for that population will be decreased significantly." - Quote from When Physicians Are In Survival Mode
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"Finally, ACOs have financial incentives and payment structures focused around quality performance and shared risk. HMOs have no measurable standards required to account for efficient, quality control and care." - Quote from ACO’s Vs HMO’s: Here’s How They’re Different
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