Tag: Value Based Care

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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Decode & Deploy: Latest Strategies in Medical Billing

It’s time to embrace the ever-evolving landscape of medical billing with Decode & Deploy! In this issue, we’ll explore cutting-edge methods for streamlining billing processes and optimizing revenue cycles including medical billing strategies. Billing in the Medical Industry: An Evolving Landscape Technology advancements, regulatory changes, and a growing focus on value-based care are driving the […]
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3 Coding Compliance Strategies to Improve Reimbursement, Quality

The Crucial Role of Medical Coding Compliance in a Value-Based World: Telling the Patient’s Story for Better Billing and Quality Care. Medical Coders: The Unsung Storytellers of Healthcare Medical coders play a critical role in hospitals, but their importance often goes unnoticed. They’re the storytellers behind the scenes, analyzing patient records, selecting billing codes, and […]
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IOTA Model

Kidney Disease Patients: Proposed Rule Aims to Increase Transplants

The organ transplant industry, like every other sector (kidney transplants IOTA model), is not free from racial disparities,” remarked U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra. “Black Americans face a disproportionate burden of life-threatening kidney disease, yet they receive a smaller share of kidney transplants. The Biden-Harris Administration is implementing concrete […]
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Boost Your Bottom Line: 4 Keys to Healthcare RCM Success

In 2024, factors like declining reimbursement rates, the shift towards value-based care, and ever-changing regulations demand a proactive approach to improve RCM. Here, we explore four key strategies to optimize your healthcare revenue cycle and ensure financial stability in the coming year. 1. Break down Silos: Merging Front-End and Back-End Functions Many healthcare organizations struggle […]
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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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independent-medical-practices

Maximizing Medicare Reimbursement: Strategies for Independent Practices

In the wake of the COVID-19 pandemic, independent medical practices face many challenges, from adapting to new healthcare methods to major regulatory changes. The main focus of this study is to increase Medicare spending. With the right strategies, independent medical practices can achieve financial sustainability while continuing to provide quality care to their patients. This […]
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 2025 CMS Proposed Rule

Proposed Rule for inpatient and LTCHs for FY 2025

2025 CMS Proposed Rule: Announcing this week a proposed rule for inpatient and long-term care hospitals (LTCHs) for the fiscal year of 2025 (FY), federal officials cited an increasing focus on social determinants of health (SDoH). The Centers for Medicare & Medicaid Services (CMS) also prioritized improving maternal health and strengthening emergency preparedness, which noted […]
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future medical coding 2024

6 Key Trends Shaping the Future of Medical Coding in 2024

Medical coding is a dynamic field, driven as much by technological advancements as by healthcare practices and regulatory changes. As we are moving into 2024, we can see that several important trends are shaping the future of this important field. Future of Medical Coding in 2024: 1. Rise of Artificial Intelligence (AI) and Machine Learning […]
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Driving Revenue Growth: Key Insights for RCM Professionals

The importance of Revenue Cycle Management (RCM) is no longer just a best practice in today’s ever-changing healthcare landscape – it has become a necessity. In a market where costs are rising, regulations are becoming more complex, and patients are becoming more responsible for their own finances, optimizing the revenue cycle is essential to maintain […]
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