Tag: Patient Outcomes

TEAM: CMS’s New Value-Based Payment for Surgeries

The Centers for Medicare & Medicaid Services (CMS) is introducing a new way to pay for specific surgical procedures: Transforming Episode Accountability Model (TEAM). This mandatory model, starting January 1, 2026, will hold hospitals accountable for the cost and quality of care for 30 days after five types of surgeries: Lower extremity joint replacement Surgical […]
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Medical coding Audits

Medical Coding Audits: Trends and Guide for Providers

The landscape of medical coding audits is constantly evolving.  Staying informed about these trends and implementing best practices can significantly reduce stress and ensure a smooth audit experience. The Shifting Landscape of Medical Coding Audits Traditionally, medical coding audits felt like a lottery. Providers faced the uncertainty of random reviews, often scrambling to address issues […]
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value based care strategies

 7 key strategies for value-based care in Physician Practices

The Centers for Medicare and Medicaid Services have encouraged physician practices to adopt a value-based care payment model since 2010, following the passage of the Affordable Care Act. A number of models have been tested in order to improve patient outcomes and experiences while reducing unnecessary healthcare expenditures by incentivizing clinicians to provide preventive, proactive, […]
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CMS Improves Outcomes & Reduces Costs with Specialty Care

Specialty care improves outcomes and reduces costs for CMS

Streamlining Specialty Care: CMS’s Innovation Center prioritizes strategies that improve personalized healthcare information, implement financial services, and support segment-based classifications. A value-based approach to care must address underlying issues and individualized care to reduce patient outcomes. CMS’s innovation strategy describes ongoing efforts to integrate personalized care into the healthcare system. Previous studies have shown that […]
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Value-Based-Care-Plans-improved-health-outcomes-for-MA-members

Medicare Advantage Value-Based Care: Enhanced Health Outcomes

Alongside its positive impact on health outcomes, the Medicare Advantage value-based care plans implemented by an insurance provider resulted in a significant $8 billion in cost savings throughout 2022. Reports from the payer revealed that Medicare Advantage beneficiaries under value-based care exhibited improved health conditions, marked by reduced inpatient admissions and emergency room visits. The […]
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Medical Billing Strategies

4 Strategies to Optimize Billing and Expand Your Customer Base

The increasing demand for incontinence products is prompting home medical equipment (HME) providers to reevaluate their existing incontinence programs. With the U.S. witnessing a significant rise in the aging population, marked by 10,000 people turning 65 every day according to the U.N. Population Division, there is a growing market for incontinence products. Studies from Mayo […]
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AI Reduces Surprise Bills

Enhancing Payment Integrity With AI To Eliminate Surprise Bills

It’s common for people to feel surprised by the cost of hospital, medical imaging, or outpatient surgery bills. Unfortunately, it’s difficult for them to verify whether the bill is accurate or not. This is because incorrect medical bills have become increasingly common. To address this issue, organizations are turning to technologies such as artificial intelligence […]
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Impact of CARE Act laws

Impact of CARE Act laws on Patient Outcomes

Policies designed to improve communication with patients and caregivers during hospitalization appear to be leading to better outcomes, researchers have found. Researchers with the University of Pennsylvania examined the impact of state laws that bring the caregiver into the process. The findings of the study were published May 1 in Jama Network Open. Since 2014, 42 states have […]
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Patient Care Advancement

5 Medical Advances That Changes Patient Care’s Future

Every day, scientists strive to solve some of medicine’s toughest questions. Here’s a look at recent breakthroughs that tackle painful conditions and deadly diseases. Gene sequencing at record speeds to identify dangerous mutations. A treatment that delays Type 1 diabetes for years. A vaccine to prevent RSV infections, which kill thousands of Americans each year. […]
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