Health plans, Centers for Medicare and Medicaid Services (CMS), and national news are touting the ongoing move from straight fee-for-service healthcare into fee-for-value healthcare. Upon initial glance, fee-for-value models absolutely provide new revenue streams for healthcare providers. However, when considering…
With 82% of hospitals and 64% of Merit-Based Incentive Payment System (MIPS) Eligible Clinicians using EHR technology supported by Fast Healthcare Interoperability Resources (FHIR®), it might be time for patients, providers, and health systems to finally expect complete and centralized…
Between 2013 and 2017, nearly twice as many rural hospitals (64) closed their doors than the previous 5-year period; predominately located in the south, according to a recent publication by the U.S. Government Accountability Office. Through shrinking commercial reimbursement rates,…
From mergers and vertical integrations to changes in quality reporting and technology, Healthcare in America continues to evolve with an eye on access, quality, and efficiency. Here is a look back at some of the major headlines of 2018. …
Medicare Advantage plans continue their unabated growth; in 2019, plan options across the United States have grown by 20% from 3,100 plans in 2018 to 3,700 plans in 2019. By 2025, it is expected that Medicare Advantage market saturation will…
Narrow networks have surged in attempts for health plans and employers to tame rising healthcare costs. In many ways, patients negatively associate the phrase, “out-of-network” with arbitrary limitations of their choice. Frustrating, we’ve all felt it. How then can provider…
Introducing continuity of care measures to the Quality Payment Program (QPP) may be the best route to lower healthcare costs and reduce hospitalizations according to a study recently published in the Annals of Family Medicine. Provider-level measures that support value-based…
Mistaking Inaction for Action Hesitant leaders can easily raise the red flag at any one of the many unclear pathways to success, that Clinically Integrated Network (CIN) conversationalists claim when discussing the ability to cultivate true innovation capable of both…
In 2019 the Centers for Medicare and Medicaid (CMS) are making changes to the Quality Payment Program (QPP). Below are the most impactful changes we think you need to know about. For additional information, click one of the links at…
In recent years, the uneven playing field between the large carriers in Georgia and the rank and file physician practices across the state has become even more skewed toward these payers. More aggressive tactics have littered the physician landscape recently,…