On December 27, 2017, CMS published Part 1 of this year’s Medicare Advantage (MA) Advance Notice highlighting proposed changes in MA payments for 2019. CMS requires comments on this Part […]
The prevention and management of chronic health conditions will have the greatest impact on reducing healthcare costs, improving quality of life and reducing mortality. A 2017 RAND study estimates that […]
Hierarchical Condition Categories (HCCs) have been the underlying risk adjustment for many Medicare programs for several years. But they didn’t attract wide interest until CMS began shifting more payment toward […]
L. Gordon Moore and Donna Smith discuss how appropriate documentation and coding of hierarchical condition categories (HCCs) can have a significant impact on payment in a value-based system.
In 2012, the Centers for Medicare and Medicaid Services (CMS) began its Hospital Readmissions Reduction Program (HRRP). The program, included in the Affordable Care Act, was designed to improve post-acute […]
Thanks for reading the Inside Angle blog in 2017! As 2018 approaches, revisit some of our most popular blogs of the year: 1. HCCs: A frequent factor in the value […]
In a representative survey of 300 hospitals and health systems, the Deloitte Center for Health Solutions discovered that: “80 percent of hospital respondents reported that leadership is committed to establishing […]
3 questions to consider when linking physical and behavioral health services.
Discussion of five best practices that help Medicaid agencies transition toward value-based care.
The consumer-directed health plan (“high deductible”) remains a popular insurance option, theoretically leaving patients more empowered than ever to optimize the Triple Aim initiative (maximum health and quality while minimizing […]
The role of the primary care provider is to serve as a generalist in managing their patients’ health. Specialists are available to provide expert opinion or specific procedures beyond the […]
New York is one of many states in the process of reforming the way it pays providers through a Delivery System Reform Incentive Payment (DSRIP) program. The goal is to […]