Category Archives: Physician Alignment

Physician Thought Leaders of Tomorrow Must Be Willing to “Rock the Boat”

What kind of individuals are best equipped to engage and lead other physicians in the coming years? Those who are willing to “rock the boat,” and then hold on to the sides of the boat even as it sinks, says … finish reading Physician Thought Leaders of Tomorrow Must Be Willing to “Rock the Boat”

Posted in affordable care act, Alternative Healthcare Coverage, Bundled Payments, Care Coordination, Incentives, Medicare, Physician Alignment, Physician Organizations, Uncategorized | Tagged , , , | Leave a comment

Nearly 20 Million Misdirected Physician Referrals Lead to Billions in Wasteful Spending

Nearly 20 million misdirected physician referrals in the United States could be leading to billions of dollars in wasteful spending across the country’s healthcare system, according to a new physician survey from Kyruus, an enterprise healthcare solutions company. Massive inefficiencies … finish reading Nearly 20 Million Misdirected Physician Referrals Lead to Billions in Wasteful Spending

Posted in Avoidable Hospitalization, Care Coordination, Clinical Integration, Healthcare Costs, Physician Alignment, Physician Organizations | Tagged , , , , | Leave a comment

CMS Releases Final Medicare Payment Rules for Value-Based Modifier, Chronic Care Management

CMS has released final rules outlining how Medicare will pay major healthcare providers and suppliers in 2015, including the Value-based Payment Modifier (VBM), which adjusts traditional Medicare payments to physicians and other eligible professionals based on the quality and cost … finish reading CMS Releases Final Medicare Payment Rules for Value-Based Modifier, Chronic Care Management

Posted in Accountable Care Organizations, affordable care act, Alternative Healthcare Coverage, Avoidable Hospitalization, Bundled Payments, Care Coordination, Case Managers, Disease Management, Healthcare Costs, Healthcare Reform, Physician Alignment | Tagged , , , , | Leave a comment

CMS Releases Data on Financial Relationships Between Healthcare Industry, Doctors, Teaching Hospitals

Designed to help consumers understand the financial relationships between healthcare industry officials, physicians and teaching hospitals, and promote transparency and accountability, CMS has released the first round of Open Payments. The program, created by the Affordable Care Act (ACA), lists … finish reading CMS Releases Data on Financial Relationships Between Healthcare Industry, Doctors, Teaching Hospitals

Posted in affordable care act, Hospital Ranking, Hospital Services, Physician Alignment, Physician Organizations, Prescription Drugs | Tagged , , , , , | Leave a comment

6 Elements of Highmark’s Pay-for-Performance ‘Best Practices’ Project

At Highmark Inc., physicians are eligible for bonus payments across a broad spectrum of measures from clinical and quality measures to prescribing habits, access to care and level of technology use. In addition, practices can also qualify for a bonus … finish reading 6 Elements of Highmark’s Pay-for-Performance ‘Best Practices’ Project

Posted in affordable care act, Comprehensive Primary Care Programs, Healthcare Reform, Healthcare Utilization, pay-for-performance, Physician Alignment | Tagged , , | Leave a comment

Patient Engagement Still Challenges Pioneer ACO

As a top performer in year one of the CMS Pioneer ACO program, Monarch HealthCare is paving the way to accountable care with a foundation of patient- and provider-centered strategies that support Triple Aim goals. Here, Colin LeClair, executive director … finish reading Patient Engagement Still Challenges Pioneer ACO

Posted in Accountable Care Organizations, Care Coordination, Physician Alignment, Physician Organizations, Population Health Management | Tagged , , | Leave a comment

United States Ranks Last on Measures of Access, Quality and Care Coordination

Despite spending nearly double that of other countries on healthcare per person, the United States ranks last on measures of access, equity, quality, efficiency and healthy lives, according to a new Commonwealth Fund report. The United States spent $8,508 per … finish reading United States Ranks Last on Measures of Access, Quality and Care Coordination

Posted in affordable care act, Care Coordination, Care Transitions, Physician Alignment, Primary Care | Tagged , , , | Leave a comment

5 Characteristics of a Value-Based Physician Compensation Model

While there is no ‘one size fits all’ physician reimbursement model, some methods, like risk-adjusting populations and ensuring colleague satisfaction, have proven integral in today’s value-based healthcare sphere. Here, Cynthia Kilroy, senior vice president of provider strategy and business development … finish reading 5 Characteristics of a Value-Based Physician Compensation Model

Posted in affordable care act, Care Coordination, Health Risk Assessment and Stratification, Healthcare Costs, Physician Alignment | Tagged , , , | Leave a comment

Physician Quality Reporting and E-Prescribing Use Increasing: CMS

Participation in two key CMS programs, the Medicare Physician Quality Reporting System (PQRS) and the Electronic Prescribing Incentive Program (eRx), increased significantly in 2012, according to the 2012 Physician Quality Reporting System and Electronic Prescribing (eRx) Experience Report. These two … finish reading Physician Quality Reporting and E-Prescribing Use Increasing: CMS

Posted in affordable care act, Healthcare Costs, Healthcare Information Technology, Healthcare IT, Physician Alignment | Tagged , , , | Leave a comment

3 Ways Hospitals Should Proceed with ACOs

Deciding which physicians you want to partner with, and how you will provide them with an opportunity that’s attractive enough so they will partner with you, is one of the steps hospitals need to take when proceeding with an ACO, … finish reading 3 Ways Hospitals Should Proceed with ACOs

Posted in Accountable Care Organizations, Healthcare Costs, Hospital Ranking, Physician Alignment, Physician Hospital Organizations, Physician Organizations | Tagged , , | Leave a comment