Nearly One-Third of Traditional Medicare Payments Now Based on Value-Based Reimbursement and Alternative Payment Models

Faster than expected transition from fee-for-service healthcare should grab attention of clinical laboratories and anatomic pathology groups who face financial unknowns under new payment systems Clinical laboratory executives should take note of a key financial fact. The transition from fee-for-service healthcare to value-based reimbursement is occurring at a faster clip than the Department of Health and Human Services (HHS) anticipated last year when federal officials announced a plan to tie...

Even as Medicare ACOs Delivered Mixed Results in 2014, Primary Care Physicians Were Awarded Biggest Share of Bonus Payments

AJMC study shows ACOs that allocate majority of shared savings to primary care providers are more likely to generate savings When it came time to pay bonuses to Medicare’s Pioneer ACOs and Shared Savings Program (MSSP) ACOs based on 2014 results, a substantial proportion of the payments went to primary care physicians compared to hospitals and specialist physicians. Significantly, only a minority of these ACOs qualified for bonus payments. Pathologists and clinical laboratory managers watching...
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