Value-based reimbursement in healthcare, or VBR, is the movement of care from fee-for-service-based models to care with incentives based on quality. The traditional fee-for-service model has incentivized quantity. Value-based reimbursement…
Category: Assessment & Benchmarks
Medical Revenue Cycle in 9 Steps
The medical revenue cycle is the process of managing a patient’s account from the beginning, when they are pre-screened for financial coverage and their account is created, to the final…
Value-Based Reimbursement Transition
Value-Based Reimbursement-laying the groundwork for a transition to it is crucial. As healthcare spending continues to rise, the Centers for Medicare & Medicaid Services (CMS) is looking for ways to…
Physician Practice Revenue Cycle – 8 Basic Best Practices
The physician practice revenue cycle is the one thing which will sustain a practice to provide patient care without undue “cash flow problems.” Even if you have a premier healthcare…
Revenue Cycle Services in Healthcare – 3 Tactical Outsourcing Observations
It’s a decision all healthcare organizations must struggle with at some point when assessing their revenue cycle services: Does it make more sense to outsource revenue cycle services or keep…
Value-Based Reimbursement Models
There’s a reason the healthcare industry is shifting toward value-based reimbursement models and away from volume-based care. Value-based care reimburses healthcare providers based on the quality of care they provide,…
How to Increase Medical Practice Collections – avoid these 4 mistakes!
If you’re wondering how to increase medical practice collections, start by making sure you’re avoiding 4 common mistakes. Let’s look closer. The challenge to increase medical practice collections The…
Revenue Cycle Management Solutions in Healthcare – 9 plus 9
With the trending shift away from fee-based service and toward value-based care, it will become even more essential to find revenue cycle management solutions in healthcare, which are effective. Healthcare organizations…
CMS Value-Based Payment Goals
In April of 2019, the Centers for Medicare and Medicaid Services (CMS) announced it is rolling out a new set of CMS value-based payment goals. It’s called the CMS Primary…
Revenue Cycle Management Process in Medical Billing – 5 Steps
Anyone who knows anything about medical billing knows there are serious issues when you’re trying to integrate a Revenue Cycle Management (RCM) process in medical billing. An essential understanding of…
Pay for Performance Reimbursement
In this post, we explain “pay for performance reimbursement”, what it is, and how it measures quality of care. Then we’ll explore some working examples. The concept of this method…
Outcome-Based Reimbursement
A lot is said these days about Outcome-Based Reimbursement in healthcare. But what exactly is that, and how does it work? Let’s take a look. Five years ago, most of…
Healthcare Revenue Cycle Process
The healthcare revenue cycle process is a non-organic process – non-organic because steps cannot be reversed, skipped or circumvented to save time or collect money faster. Missing or skipping a…
Fee-for-Service vs. Value-Based Reimbursement
The cost of medical care has outpaced inflation for several years now, and it shows no signs of slowing. Despite skyrocketing costs, care quality is not improving under the traditional…
Revenue Cycle Management Outsourcing
According to a recent Black Book Survey, revenue cycle management outsourcing stood at $11.7 billion at the close of 2017 and is expected to climb to $23 billion by 2023….
Healthcare Revenue Cycle Flowchart in 5 Steps
Healthcare revenue cycle management is a complex and complicated process that can drain resources when not properly managed. It takes considerable time and expertise to create and manage a well-maintained…
Value Based Care Reimbursement
A recent Black Book survey found that hospitals and other providers are gearing up to outsource key functions, including a move to outsource revenue cycle management to third-party vendors. Medical…
A Medical Billing Audit can Increase Profitability
A Medical billing audit is often thought of as a defensive measure. A government or private payor has denied or pended a series of claims. Now they want copies of…
Physician Revenue Cycle Key Indicators of Best Practices
Physician revenue cycle operations continue to transform fundamental aspects of modern medical practice. The current unsustainable system drafts individual elements of the revenue cycle in search of success, often ignoring…
What is Value Based Reimbursement Looking Like in 2019?
Change is a constant in the healthcare industry, and for all healthcare providers submitting claims to Medicare it’s important to carefully review your processes based on what’s to come with…