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Value Based

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Value Based
Value Based

What Is The Physician Payments Sunshine Act?

By

Scott Hodgin

|

January 15, 2019

The Physician Payments Sunshine Act (PPSA) was introduced in the United States Congress on September 6th, 2007 by Senators Charles Grassley (R-IA) and Herb Kohl (D-WI). The goal of the bill was to “shed light” on the nature and extent of financial relationships between physicians and teaching hospitals and the applicable manufacturers and group purchasing organizations (GPOs) they interact with. The expectations were that the bill would reveal the potential overall effect that these relationships have...

Value Based

Value-based Purchasing: What is it?

By

Scott Hodgin

|

January 15, 2019

Value-based purchasing (VBP) is a methodology of healthcare payment reform that focuses on paying providers for quality and value, not just volume. Sometimes referred to as “pay-for-performance” (P4P), value-based purchasing is becoming the new normal in healthcare, linking provider reimbursements to quality measures and cost-efficiency. The traditional fee-for-service (FFS) payment model is “morphing” into alternative payment models (APMs) that increase provider accountability for both quality and total cost of care, while requiring a greater focus..

Value Based

The Five Conceptual Templates for Value-Based Reimbursement

By

Scott Hodgin

|

January 15, 2019

The healthcare industry is in the middle of a payment structure overhaul. The conventional fee-for-service (FFS) reimbursement model is slowly being replaced by an assortment of value-based reimbursement (VBR) models aimed at encouraging healthcare providers to deliver the best quality care at the most reasonable cost, thus improving the overall value of care. In January 2015, the Department of Health and Human Resources (HHS) announced its intention to link 50% of all traditional Medicare payments to value-based reimbursement models by...

Value Based

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

By

Scott Hodgin

|

January 15, 2019

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...

Value Based

Value-based Care vs Fee-for-Service

By

Scott Hodgin

|

January 15, 2019

The healthcare industry is experiencing a transformation involving reimbursement payment models. The conventional fee-for-service (FFS) reimbursement model is slowly being replaced by the concept of value-based care, a reimbursement methodology that challenges the “volume-based care” associated with fee-for-service...

Value Based

How Value Based Care Differs From Traditional Care

By

Scott Hodgin

|

January 15, 2019

With the proposal and implementation of the Affordable Care Act in 2010, lawmakers searched for ways to reduce the national deficit. Baby boomers would soon be entering retirement age, and the costs of caring for the elderly and disabled Americans were expected to soar. Medicare became...

featured posts
Value Based

Value-based Care vs Fee-for-Service

The healthcare industry is experiencing a transformation involving reimbursement payment models. The conventional fee-for-service (FFS) reimbursement model is slowly being replaced by the concept of value-based care, a reimbursement methodology that challenges the “volume-based care” associated with fee-for-service...

accountable-care-organization

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

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...

Value Based

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

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...