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Published By: HealthLeaders Media     Published Date: Oct 08, 2015
The Centers for Medicare & Medicaid Services, the nationís largest payer, has set a clear direction with its publication of targets: By 2018, 50% of fee-for-service payments will be through alternative payment models, such as ACOs and bundled payments, and 90% of FFS payments will be tied to quality or value. And CMS has begun to introduce mandatory bundles. This suggests that all providers will need to develop population health competencies, including the ability to manage risk for both cost and quality.
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HealthLeaders Media
Published By: Truven Health Analytics     Published Date: Oct 01, 2015
Medicare spend per beneficiary (MSPB) information is a Centers for Medicare & Medicaid Services metric that reflects the average cost of an episode of care for Medicare patients. This measure is important to consider as part of a hospitalís national balanced scorecard, as it reflects executivesí efforts to transform the healthcare delivery system and manage the full continuum of care, including the prominent shift from inpatient to outpatient utilization.
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Truven Health Analytics
Published By: Truven Health Analytics     Published Date: Dec 01, 2014
The Truven Health Analytics 50 Top Cardiovascular Hospitals study identifies hospitals that achieve the best performance on a scorecard of performance measures. This year, based on comparisons between the winners and a peer group of similar high-volume hospitals that were not winners, the study found that if all cardiovascular providers performed at the level of this yearís winners, approximately 9,500 additional patients could survive, more than $1 billion could be saved, and almost 3,000 additional bypass and angioplasty patients could be complication-free. This is based on an analysis of Medicare patients; if the same standards were applied to all inpatients, the impact would be even greater.
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Truven Health Analytics
Published By: The SSI Group, Inc.     Published Date: Mar 31, 2015
In late August 2014, the Centers for Medicare and Medicaid Services (CMS) announced plans to reinstate the Recovery Audit program on a limited basis. CMS reports the delay in restarting the Recovery Audit program was to enable the various RAC regions to restructure, allowing time for the appeals to catch up. Soon, however, the hiatus will end and RACs in all regions will resume automated reviews; these will be in addition to select complex reviews based on topics chosen by CMS.
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The SSI Group, Inc.
Published By: The SSI Group, Inc.     Published Date: Oct 23, 2015
Healthcare billing and claims handling has become increasingly complex. With the transition to Version 5010 of the HIPAA electronic transaction standards, the expansion of billing codes under ICD-10, and the ever-changing requirements of insurance companies and the Centers for Medicare and Medicaid Services (CMS), it can be nearly impossible for providers to keep up.
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The SSI Group, Inc.
Published By: Extend Health     Published Date: Jul 09, 2012
With the group model becoming increasingly unsustainable, how do you cut costs and still take care of your retirees? Extend Health's Medicare Exchange could be your answer.
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Extend Health
Published By: Transamerica Retirement Management     Published Date: Jun 03, 2011
76 million baby boomers are ready to redefine retirement. Are they-or you-ready for what's to come? See what other benefits directors are saying. Download our free white paper.
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transamerica retirement management, benefits directors, baby boomers, padilla spear beardsley, employees, investments, medicare, social security
    
Transamerica Retirement Management
Published By: Allscripts     Published Date: Oct 29, 2014
Download this case study to learn how SAMA HealthCare Services uses an Open platform from Allscripts to customize its healthy EHR core and focus on preventative care that is keeping patients out of the emergency room. The results? An estimated savings of $2.6 million in unnecessary ER visits and $2 million earned for Comprehensive Primary Care Initiative and Meaningful Use.
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allscripts, healthy ehr core, comprehensive primary care, sama healthcare services, open platform, patient centered primary care, medicare, edoc4u
    
Allscripts
Published By: Allscripts     Published Date: Oct 30, 2015
Download our ebook today to discover how Allscripts Value-based Care Services can help your practice adjust to changing reimbursement trends.
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medicare, value-based reimbursement models, revenue growth, value-based care, allscripts, community care solutions, chronic care management solutions, analytics
    
Allscripts
Published By: JBoss Developer     Published Date: Oct 21, 2016
TMG Health, the largest business process outsourcing (BPO) provider in the Medicare and Medicaid market, relied on a slow, batch-oriented legacy application environment that prevented it from providing continuous data visibility and access to its clients. With help from Red Hat Consulting, TMG deployed a new application platform using Red Hat JBoss Enterprise Application Platform and other Red Hat solutions. As a result, TMG reduced development time and costs and delivered real-time data access and visibility to its clients.
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consulting, efficiency, data, api, java
    
JBoss Developer
Published By: RelayHealth     Published Date: Mar 29, 2013
Operating Rules Countdown: Enforcement Action Began April 1 - The Centers for Medicare and Medicaid Services (CMS) announced in January that enforcement action for Phase I and II Operating Rules was delayed until March 31, 2013. This phase of Operating Rules is related to enhanced delivery and content of eligibility and claim status responses.
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operating, medicare, services, rules, eligibility, claim
    
RelayHealth
Published By: Allscripts     Published Date: Jun 05, 2013
This paper explores the unique perspectives of both types of organizations. The participants include two of the original 32 Pioneer ACOs; the nationís largest commercial ACO; a major IDN that is pursuing its own ACO pathway; a large stand-alone hospital that has yet to take the formal step of creating an ACO but is experimenting with the model; and a large, independent, multispecialty physician group that is wary of stepping into the ACO waters.
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aco, idn, accountable care organization, medicare, reimbursement, business intelligence, enterprise resource planning, healthcare reform
    
Allscripts
Published By: CareCloud     Published Date: Sep 23, 2014
Gastroenterology practices today are under immense pressure from the combination of declining reimbursement and rising costs. Among other recent challenges, CMSís dramatic cuts to the 2014 Medicare reimbursement rates for upper GI endoscopy services dealt a tough blow to gastroenterologists across the country.
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carecloud, gastroenterology, profitability, medicare reimbursement, rising costs
    
CareCloud
Published By: athenahealth     Published Date: Oct 07, 2015
This whitepaper is a step-by-step ďplaybookĒ based on athenahealth's work with clients who have seen success and shared in savings through the Medicare Shared Savings Program (MSSP).
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medicare shared savings, mssp, medicare, accountable care organizations, healthcare expenditures, population health management, practice management
    
athenahealth
Published By: Comcast     Published Date: Apr 11, 2017
Like healthcare organizations elsewhere, reducing readmissions had become a top priority by 2011. Advocate, the stateís largest healthcare provider, had just signed its first shared savings agreement with Blue Cross Blue Shield of Illinois to become one of the first commercial accountable care organizations (ACOs) in the country. This event, along with others such as signing up as a Medicare Shared Savings Provider, led to re-evaluating the care continuum throughout Advocate Healthís 250 sites of care, including 13 acute-care hospitals, two childrenís hospitals and a growing home healthcare division.
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healthcare, organizations, readmissions, comcast, blue cross shield
    
Comcast
Published By: ZirMed     Published Date: Feb 05, 2013
This white paper examines the issues and risks surrounding compliance and reimbursement, and how a management tool can help you avoid them.
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compliance, medicare, medicare, reimbursement, claims management, claims, coding, electronic health records
    
ZirMed
Published By: Entrust Datacard     Published Date: May 15, 2014
Entrust Solutions for Centers for Medicare & Medicaid Services Authentication Compliance
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entrust, healthcare, cms systems, medicare, medicaid
    
Entrust Datacard
Published By: Entrust Datacard     Published Date: Jul 21, 2014
As an expert in multifactor and identity authentication, Entrust provides capabilities to healthcare organizations that far surpass the regulations.
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authentication, healthcare, medicine, identity, security, cms system, information technology
    
Entrust Datacard
Published By: Hacker Group, Inc.     Published Date: Jan 27, 2012
Health insurance marketing is highly regulated and nuanced with complexities. Success depends upon marketers' - and their agencies' - ability to exploit knowledge of the regulatory environment as well as specialized direct/digital practices. Category expertise is critical.
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healthcare marketing, health care marketing, health insurance marketing, medicare marketing, health care marketing ideas, health care marketing plan, health insurance marketing strategies, ideas for healthcare marketing
    
Hacker Group, Inc.
Published By: Medical Group Management Association (MGMA)     Published Date: Jun 25, 2009
MGMA Connexion™ magazine is the medical group practice professional's power resource. This popular magazine is filled with insight from peers, advice from experts and timely information on a variety of cutting-edge healthcare industry topics. MGMA Connexion™ magazine ranks as the "must-read" magazine for nearly 23,000 Medical Group Management (MGMA) members. MGMA's flagship publication is distributed ten times per year with a circulation well beyond the nearly 23,000 readers. About 50% or readers report the MGMA that they pass the issues on to other readers. This sample issue includes trend stories and member case studies, providing you a behind-the-scenes perspective on the group practice industry.
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mgma, connexion, medical, ehr, physician recruiting, medicare, private, ids
    
Medical Group Management Association (MGMA)
Published By: Medical Group Management Association (MGMA)     Published Date: Sep 23, 2009
In this highly informative piece, authors Cynthia L. Dunn, RN, FACMPE and Rosemarie Nelson, MS, healthcare industry leading experts and principal consultants for the MGMA Health Care Consulting Group (www.mgma.com/consulting) have composed an in-depth look at the medical practice of the future that will allow you to learn about the following.
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mgma, connexion, medical, ehr, physician recruiting, medicare, private, ids
    
Medical Group Management Association (MGMA)
Published By: CBIZ     Published Date: Aug 27, 2013
Are you prepared for health care reform? This 3-page checklist guides you through the general compliance requirements of the Affordable Care Act (ACA) to help you prepare now for 2014 and beyond. The checklist is broken down into five categories: 1. Health Plan Action Items; 2. Employer Tax Changes; 3. Fees and Filings; 4. Shared Responsibility Employer Preparation; and 5. ACA Provisions beyond 2014.
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health care reform, health reform checklist, affordable care act, aca, shared responsibility, grandfathered, waiting period, summary of benefits and coverage
    
CBIZ
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