Clinical, Financial and Administrative Insights For Physicians

Value Based Care | Pay for Performance Model in Healthcare | RevenueXL

Posted by Suzanne Prasad

Value Based Care

Value-based care is healthcare delivery model in which provider reimbursement is tied to the quality of care provided (measured by patient health outcomes) and rewards providers for both efficiency and effectiveness. Under value-based care agreements, providers are rewarded for helping patients improve their health, reduce the effects and incidence of chronic disease, and live healthier lives in an evidence-based way.

The transition from fee-for-service to value-based care or pay for performance represents a paradigm shift for the entire healthcare industry but also promises specific opportunities and challenges for individual providers. If you’re considering transitioning to a value-based reimbursement model, it is important to learn as much as possible about the two systems, the changes ahead of you, as well as your strategic options.

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What is MIPS ? : 5 Key Concepts Physicians need to know

Posted by Alok Prasad

What is MIPS?

Medicare reform—specifically the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APM)—is the number one issue affecting physicians in 2016, according to the American Medical Association.  That’s because beginning in 2019, physicians must choose to participate in either MIPS or APMs as part of a larger shift away from fee-for-service payment toward value-based reimbursement.

Although 2019 may seem far away, the reality is that many practices need to start researching their options now. Navigating through this complex payment maze takes time and effort.

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5 Key Alternative Payment Models (APM) Concepts Physicians need to know Today

Posted by Suzanne Prasad

What is APM?

After years of physician payment cuts based on a flawed Medicare sustainable growth rate, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)  establishes two payment tracks from which physicians must choose beginning in January 2019: the Merit-Based Incentive Payment System (MIPS) or an Alternative Payment Model (APM). This article focuses five concepts physicians need to understand about APMs. In a followup post next week, we will provide an explaination on MIPS. 

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