The Value-Based Care Movement: What’s Working, What’s Not

Value-based care is the emerging alternative to Fee-for-Service reimbursement–based on quality rather than quantity. Value-Based Care basics Value-based care (VBC) is a reimbursement system that rewards providers for efficiency and effectiveness in providing care. Compared to fee-for-service models, this form of reimbursement allows providers retrospective compensation for services delivered based on bill charges or annual…

Quality Care Measurement: Understanding Statistical Significance

The amount of healthcare data is growing at an astounding rate. Statistical significance is used by quality improvement administrators to determine whether differences in quality are likely to occur by chance. This data presents a valuable opportunity for healthcare organizations. Using healthcare data to build better quality improvement programs Health care organizations use data to…

How to Combat the Burden of Prior Authorizations

Prior Authorizations in practice Payers use Prior Authorization to control costs and ensure their members receive only medically necessary care, before providing specific services or items to a patient, providers must obtain payer approval in advance. Providers are now burdened with the process of obtaining prior approval for services. Group medical practice executives cited Prior…

Next Round of Information Blocking Requirements Take Effect October 2022: The 21st Century Cures Act

Determine what impact The 21st Century Cures Act legislation was enacted with the goal of increasing choice and access for patients and providers in 2016. The law authorizes funding to address the opioid epidemic and improve mental health services. Current funding encourages expedited approval of new drugs, devices, and treatments. As of October 6, 2022,…