Quality, Reimbursement and Reporting

The Centers for Medicare and Medicaid Services (CMS) started the shift to becoming a value-based purchaser well before health care reform. With passage of the Accountable Care Act, CMS is charged with developing and implementing sweeping value-based purchasing programs, in which, providers will be paid for: 1) the delivery of high-quality patient care, as demonstrated by the reporting of specified evidence-based quality measures; 2) the reduction of medical errors, preventable re-admissions, and unnecessary and/or ineffective procedures; and 3) the prudent purchasing of medical services, supplies and equipment. This will require the intentional alignment of incentives between and among clinicians, hospitals, extended care facilities, home health providers and others. It will also, most likely, require a fundamental shift from the current fee-for-service system toward the evolution of a set of bundled payment approaches. As the nation's largest health care focused law firm, Hall Render has gained extensive experience in working with hospitals, physician groups, and other health care providers and suppliers to form new business relationships, navigate the myriad of regulatory and commercial payer requirements and adapt to shifting financial models. Our knowledge and experience can assist your organization in preparing for and implementing the changes necessary to ensure your organization's continued success.

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