The Intersection of Medicare Value Based Care and nThrive's Transformation in Revenue Cycle Management

Ben H.

Hatched by Ben H.

Nov 02, 2023

4 min read

0

The Intersection of Medicare Value Based Care and nThrive's Transformation in Revenue Cycle Management

Introduction:

Medicare Value Based Care (VBC) is a significant component of our healthcare system, with the Medicare Shared Savings Program (MSSP) being the largest VBC system in the nation. Since its inception in 2012, the MSSP has achieved remarkable success, saving billions of dollars in healthcare expenditures. In 2021 alone, the MSSP covered over 10.7 million beneficiaries and reported savings of $2.0 billion. As we anticipate the release of the results for the 2022 performance year, it is crucial to understand the various aspects of Medicare VBC and its implications. Simultaneously, the healthcare revenue cycle management industry is experiencing a transformative change, exemplified by nThrive's rebranding as FinThrive. This article will explore the common points between Medicare VBC and nThrive's transformation, highlighting their impact on healthcare organizations and providing actionable advice for navigating this evolving landscape.

Medicare Value Based Care:

The Medicare Shared Savings Program offers different contract options, including "One-Sided" and "Two-Sided" contracts. The former allows participating Accountable Care Organizations (ACOs) to share in savings only, while the latter enables sharing in both savings and losses. Additionally, there are two methods for assigning beneficiaries to the ACO risk pools: "Prospective" and "Retrospective." These variations in contracts and risk assignment methods provide flexibility for ACOs to tailor their participation in Medicare VBC to their specific needs.

nThrive's Transformation to FinThrive:

nThrive, a healthcare revenue cycle management software-as-a-service (SaaS) platform provider, recently announced its name change to FinThrive as part of a forthcoming rebrand. The company aims to revolutionize revenue cycle management by offering an end-to-end SaaS platform that streamlines financial processes and optimizes revenue. By eliminating the burden of managing disparate systems and vendors, FinThrive allows financial teams to focus on revenue optimization and financial health. The platform's integrated cloud-based software automates administrative tasks, reduces errors, improves productivity, and increases profitability. These capabilities empower financial teams to enhance operational performance, increase efficiency, and improve the patient experience.

Common Points and Impact on Healthcare Organizations:

Both Medicare VBC and FinThrive's transformation have a profound impact on healthcare organizations. By participating in Medicare VBC, ACOs have the opportunity to achieve cost savings and improve patient outcomes. The ability to share in savings incentivizes ACOs to implement value-based initiatives that enhance care coordination, patient engagement, and preventive services. With the comprehensive revenue cycle management SaaS platform provided by FinThrive, healthcare organizations can optimize their revenue, reduce costs, and ensure regulatory compliance. The automation of administrative tasks and the integration of data analytics empower financial teams to make informed decisions, improve efficiency, and deliver a seamless patient experience.

Actionable Advice:

  • 1. Embrace Value-Based Care Initiatives: Healthcare organizations should actively pursue participation in Medicare VBC programs, such as the MSSP, to capitalize on the potential cost savings and improved patient outcomes. By implementing value-based initiatives, organizations can enhance care coordination, patient engagement, and preventive services, ultimately driving better overall care delivery.
  • 2. Adopt Comprehensive Revenue Cycle Management Solutions: To navigate the evolving healthcare landscape, organizations should consider implementing end-to-end revenue cycle management SaaS platforms like FinThrive. These platforms streamline financial processes, automate administrative tasks, and provide data-driven insights that optimize revenue, reduce costs, and ensure regulatory compliance. By embracing technology-driven solutions, organizations can enhance operational performance, increase efficiency, and improve the patient experience.
  • 3. Foster Collaboration and Communication: To maximize the benefits of both Medicare VBC and revenue cycle management transformation, healthcare organizations must prioritize collaboration and communication among different stakeholders. By fostering interdisciplinary cooperation, organizations can align their financial and clinical goals, drive value-based initiatives, and ensure seamless revenue cycle management. Effective communication and information sharing between financial teams, clinical staff, and administrators are essential for success in this changing landscape.

Conclusion:

The convergence of Medicare Value Based Care and nThrive's transformation to FinThrive represents a significant shift in the healthcare industry. By understanding the nuances of Medicare VBC and embracing comprehensive revenue cycle management solutions, healthcare organizations can optimize their financial performance, enhance patient outcomes, and navigate the evolving landscape successfully. By embracing value-based initiatives, adopting technology-driven solutions, and fostering collaboration, organizations can position themselves for long-term success in this changing healthcare environment.

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