Health Care Payment Reform Resource Center


Health care reimbursement is rapidly changing as Medicare and other payors are implementing Alternative Payment Models (APMs). These models are transforming care pathways as health care providers implement strategies designed to improve the quality of care while decreasing expenditures. Developing successful APM strategies necessitates having access to actionable data analytics and cross-continuum expertise. BKD recognizes the challenges these payment models present to health care providers across the continuum and has the experience to help clients navigate the transition and capitalize on the opportunities these models can present.

Finding the Value in the Charge Master – October 2017


The charge description master (CDM) is the engine of a revenue cycle. Take a look at some key CDM areas for your hospital or health system to focus on throughout the year. Read More

Don’t Miss Proposed Updates to the 2018 QPP – August 2017


On June 20, 2017, the Centers for Medicare & Medicaid Services (CMS) released its proposed updates outlining the changes to the Quality Payment Program (QPP) for 2018. The QPP, established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), began offering an incremental implementation approach for the new payment program in 2017. Read More

CMS Shifts to “Choose Your Own Risk” for Bundles – August 2017


On August 15, 2017, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to cancel three mandatory bundled payment programs with scheduled effective dates of January 1, 2018, as well as change the Comprehensive Care for Joint Replacement (CJR) model, which has been in place since April 2016. Read More

Understand the Value of Accurate CDI & Coding – June 2017


The need for quality documentation and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding in physician practices is rapidly changing in the new value-based care and quality models, including the new Quality Payment Program (QPP), recently confirmed by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Read More

Claims Data’s Power for Decision Making – June 2017


You’ve likely read articles encouraging organizations to use data to guide them through the changes involved with bundled payments. If you’re fortunate, you have a data analytics team providing valuable insights. Read More

Alert – Cardiac Arrest:  Hospitals in Mandatory Cardiac Bundling Announced – December 2016


On December 20, 2016, the Centers for Medicare & Medicaid Services (CMS) approved the mandatory expansion of new cardiac bundles within the episode payment model (EPM). This becomes effective for hospitals admitting patients on or after July 1, 2017. Read More

Alert – New Collaboration Opportunities Continue to Emerge for Home Care Providers – December 2016


Home care providers that can maintain high-quality care while reducing Medicare spending have new opportunities to position themselves as key collaborators in a new mandatory Medicare episode payment model (EPM) for cardiac rehabilitation as well as an expansion to the existing Comprehensive Care for Joint Replacement (CJR) model. Read More

Data Is Key to Navigating Collaboration Efforts in Advanced Payment Models – December 2016


For post-acute providers to succeed in the evolving landscape of advanced payment models, they need to harness data that showcases their value to potential health care collaborators. We can help you develop a strategy with BKD’s Big Data Analytics. Read More

Mastering MACRA:  Key Considerations for Success – December 2016


On October 14, 2016, the Centers for Medicare & Medicaid Services released the much anticipated final rule implementing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Read More

Alert – MACRA Final Rule Released – October 2016


On Friday, October 14, 2016, the Centers for Medicare & Medicaid Services (CMS) released a 2,398-page final rule implementing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) within the Medicare Physician Fee Schedule (MPFS). Read More

Are You Ready for a Standardized World? – September 2016


With the recent announcement of the second mandatory bundled payment program (Cardiac Rehabilitation Incentive Payment Model), Medicare reinforced its commitment to new models and the bundled approach. While only select geographic areas will be affected, health care organizations should understand these programs and their influence, even if they’re not included in a current mandatory program. Read More

Cardiac Arrest – Early Detection Could Save Your Hospital’s Bundle – July 2016


The Centers for Medicare & Medicaid Services proposed a mandatory Cardiac Rehabilitation (CR) Incentive Payment Model, which will hold hospitals financially accountable for an anchor hospitalization and 90 days of post-acute care. Providers should begin preparing for the CR and other commercial bundles that adopt Medicare definitions and pricing mechanics. Read More

Where to Start:  Strategically Navigating Advanced Payment Models as a Home Health Provider – March 2016


The health care payment landscape seems to change almost weekly, and providers are left wondering if their strategy is positioning them for opportunities—or risks. Read More

Why Post-Acute Care Providers Should Prepare for CJR – February 2016


Practically every article you read about a new law, regulation or requirement starts with, “On such-and-such date, the Centers for Medicare & Medicaid Services (CMS) issued …” and then proceeds to painstakingly outline the regulatory or legal changes. Read More

Alert – CMS Announces Final CCJR Rule – November 2015


On Monday, November 16, the Centers for Medicare & Medicaid Services (CMS) announced the finalized rule for Comprehensive Care for Joint Replacement (CCJR). Read More

Alert – CMS Proposed Rule for Lower-Extremity Joint Replacement – July 2015


On July 9, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule designed to promote “financial accountability” for the two most common surgical episodes:  MS-DRG 469 & MS-DRG 470 (lower-extremity joint replacement, or LEJR). Read More

Alert – SNF Impact of Joint Replacement Bundled Payments – July 2015


On July 9, 2015, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule on the Comprehensive Care for Joint Replacement (CCJR) demonstration model. The CCJR model is a five-year demonstration project that would test bundled payments for lower extremity joint replacements (LEJR). Read More

Physician Engagement in a Value–Based Reimbursement Environment Through Compensation Design
Presenters:   Zach Remmich & David Stein, Strategic Medical Consultants – April 25, 2017

CPE Credit:  1 CPE credit (Specialized Knowledge)


Are your physicians engaged? Are physician incentives aligned with organizational goals? Join us for a complimentary webinar discussing strategies for increasing physician engagement and improving performance. Read More

Unbundling the Cardiac Bundle – Success with Episode Payment Models
Presenters:   Eric Rogers, Lucy Zhang & David Stein, Strategic Medical Consultants – April 13, 2017

CPE Credit:  1 CPE credit (Specialized Knowledge)


This complimentary webinar will provide an overview of the cardiac bundle mandate and a discussion on how to align your physicians. In addition, there will be a demonstration of the tools that can help you make data-driven decisions, implement best practices and measure your performance against financial, operational and clinical goals. Read More

MACRA Applications & Implications Part 2:  The Final Rule
Presenters:   Mark Blessing & Zach Remmich – January 17, 2017

CPE Credit:  1.5 CPE credit (Specialized Knowledge and Applications)


This complimentary webinar outlining the effects of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule, examining the proposed rule’s changes and exploring the implications. Read More

MACRA:  Applications & Implications
Presenters:   Mark Blessing & Zach Remmich – September 13, 2016

CPE Credit:  1 CPE credit (Specialized Knowledge and Applications)


This complimentary webinar outlines strategies for assessing and addressing effects of the proposed Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) physician reimbursement changes and exploring the implications. Read More

Gainsharing:  Developing Your Collaborator Agreements & Regulatory Waivers
Presenters:   Mark Blessing & Randy Biernat – April 27, 2016

CPE Credit:  1 CPE credit (Specialized Knowledge and Applications)


This complimentary webinar will address drivers and pathways for successful collaboration arrangements and emphasize regulatory safeguards. Read More

Home Care:  Data-Driven Strategy for Bundled Payment Success
Presenters:   Karen Vance , Mark Sharp & Eric Rogers – April 20, 2016

CPE Credit:  1 CPE credit (Specialized Knowledge and Applications)


Through the use of claims data and case studies, this complimentary webinar will help home care organizations understand the magnitude of their opportunities and risk as well as the necessary action steps for moving forward. Read More

Skilled Nursing:  Data-Driven Strategy for Bundled Payment Success
Presenters:   Chris Murphy – April 20, 2016

CPE Credit:  1 CPE credit (Specialized Knowledge and Applications)


This complimentary webinar will use national claims data and case studies to show the impact payment reform will have on skilled nursing providers. Attendees will gain an understanding of how they can harness their data to seize opportunities and manage risk. Read More

Hospitals & Health Systems:  Data-Driven Strategy for Bundled Payment Success
Presenters:   Jeremy Clopton , Eddie Marmouget & Eric Rogers – April 20, 2016

CPE Credit:  1.5 CPE credit (Specialized Knowledge and Applications)


Through the use of data analytics and case studies, this complimentary webinar will help hospitals recognize the understand their opportunities and risk as well as the necessary action steps for moving forward. Read More

The post-acute care payment game is changing:  Is your team ready?
Presenters:   Chris Murphy & James Berklan, McKnight's – February 16th, 2016


The Centers for Medicare & Medicaid Services is transitioning from fee-for-service to payment models that reward more efficient, high-quality care. Read More

Understanding & Utilizing the Final CJR Rule
Presenters:   Mark Blessing , Randy Biernat & Cathy Martin, Ober|Kaler – January 27, 2016

CPE Credit:  1 CPE credit ( Specialized Knowledge and Applications)


Join us for this presentation on the final Comprehensive Care for Joint Replacement (CJR) rule. Read More

Medicare Comprehensive Care for Joint Replacement Model
Presenters:   Eric Rogers & Jeff Bond, BKD Consulting – August 13, 2015

CPE Credit:  1 CPE credit ( Specialized Knowledge and Applications)


Join BKD as we review the details of the Comprehensive Care for Joint Replacement (CCJR) proposed rule and answer important questions that will shape the transition from fee-for-service toward risk-based outcomes. Read More

FAQs



MACRA General FAQ


MACRA RHC CAH FQHC FAQ


CJR Mandate Q&A


Gainshare Arrangements Q&A


Comprehensive Primary Care Plus

Tools


Events


AICPA Health Care Industry Conference
MACRA:  Using Data to Capture the Quality
Denver, CO
November 8, 2017
Mark Blessing, Zach Remmich and Eric Rogers


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