From AI-powered diagnostics to personalized medicine, we asked twenty four healthcare executives their insights on trends and technologies that will transform patient care in the coming year. In 2025, Artificial Intelligence and the T.E.A.M. (Transforming Episode-Based Accountable Management) model will redefine care coordination, creating a smarter, faster, and more equitable healthcare system. Primary care will…
A clear trend has emerged in the health care industry: Mergers and acquisitions of health care firms have slowed year over year. Though home-based care M&A showed “signs of life” in Q3 2024 in what has otherwise been a relatively quiet year thus far, transaction volume was still down last year, according to a report…
Healthcare organizations invest significant time, energy, and money into hiring physicians. But according to Douglas Farrago, MD, the author of ‘The Hospital Guide to Physician Retention,’ very few organizations invest adequate resources into keeping physicians. Farrago, a Family physician, became interested in the topic from his personal experience as an employed physician. “I wrote this book…
In October 2024, the Task Force turned 10 years old. In recognition of this anniversary, the Task Force released a two-part paper reflecting on the past 10 years of health care transformation and envisioning a path forward for the coming decade. The Task Force’s original vision and guiding principles remain sound today, providing a strong…
Accountable Care Organizations (ACOs) are designed to streamline patient care while optimizing healthcare costs and improving outcomes. However, one key aspect that many ACOs grapple with is ensuring accurate and compliant coding and billing practices. Coding and billing compliance are essential in preventing costly errors, minimizing revenue leakage, and maintaining regulatory adherence, which is vital…
In today’s complex healthcare system, the importance of accurate coding cannot be overstated, especially regarding Hierarchical Condition Categories (HCC) coding and Medicare risk adjustment. These components are vital in ensuring that healthcare providers are adequately reimbursed while complying with regulatory requirements. For organizations that handle Medicare Advantage patients, understanding and implementing accurate HCC coding practices…
Download Slides Accurate coding is extremely important in the era of value-based care. If coding is inaccurate, it can result in significant financial penalties, damage to reputation, and missed opportunities to maximize reimbursements. Additionally, adherence to key compliance requirements and good clinical documentation practices are essential to avoid legal and financial repercussions. Key Takeaways:…
Applying data governance strategies can help healthcare facilities capture and use social determinants of health (SDOH) data, and a key part of that process is appropriate coding, according to an American Health Information Management Association (AHIMA) white paper. “When it comes to revenue cycle, I think what it comes down to is quality,” Julie A. Pursley, MSHI, RHIA,…
Each year, a growing number of providers are entering value-based care arrangements, including primary care providers (PCPs). Given their holistic view of patients, PCPs are the best types of clinicians to drive value-based care. Medicare’s Primary Care Transformation programs and many payer-developed value-based care contracts are proof of the move for PCPs to be at…
As providers and payers invest in the move from volume to value, they are facing the reality that clinicians are lacking when it comes to training, education, and technology specific to enabling value-based care over fee-for-service. In order to succeed in this transition, practicing clinicians and emerging residents need hands-on support and investment to evolve,…