Integra Connect Launches Specialty Revenue Cycle Management Service Supporting Both Fee-For-Service and Value-Based Reimbursement

May 09, 2017

Cloud-Based Service Enables Large Urology and Oncology Practices to Maximize Revenue As Reimbursement Shifts Toward MIPS and Alternative Payment Models

May 9, 2017 – West Palm Beach, FL – Integra Connect, the leading provider of technologies and services for value-based specialty care, today announced the availability of a new, turnkey revenue cycle management (RCM) service optimized for specialty practices operating under both fee-for-service and value-based payment models. The initial focus of the service is large urology and oncology practices, who see a larger percentage of Medicare recipients than other physicians and face significant disruption this year as CMS pursues its goal of converting reimbursement to the Merit-Based Incentive Payment System (MIPS), with half of all payments in Alternative Payment Models (APMs) by 2018.

Integra Connect’s cloud-based RCM service is designed to maximize revenue through the transition to value-based reimbursement, by augmenting its best-in-class payment and denial management capabilities with MIPS measurement, APM quality measurement, analysis, and contract oversight, enabling a holistic and actionable view of practice finances.

“The rise of value-based care is quickly transforming our practice’s revenue cycle. As we embrace MIPS and alternative payment models, revenue cycle management has had to take on a much more strategic role to ensure that we accurately project revenue across fee-for-service and fee-for-value activities alike,” said Dr. Mitchell B. Hollander, co-president of the Michigan Institute of Urology, a leading practice with 51 urologists across 22 locations.  “Integra Connect has built the only revenue cycle management solution we have seen that can plan, execute, and collect against a diverse range of reimbursement models – all in service of our providing the highest-quality, financially sustainable care to our patients.”

Integra Connect’s value-based RCM service includes the following components:

  • Executive-level strategy review and refinement to manage the practice’s transition to value-based care models, including holistic evaluation of the timing and magnitude of revenue shifts;
  • Expert implementation and operations teams with deep urology- and oncology-specific domain expertise to seamlessly manage the practice’s revenue cycle, from claim submission to collections across all contract types;
  • Analytics with real-time, decision support capabilities focused on MIPS and APM performance measurement and associated alignment of RCM processes across the practice, including action plans to identify proactive clinical and/or operational intervention to improve value-based outcomes.

The value-based RCM service is part of Integra Connect’s comprehensive, integrated suite of solutions that enable specialty groups to optimize clinical and financial performance for value-based care.  It can be complemented by Integra Connect’s population health capabilities, which provide the technologies and services for practices to stratify their high-risk patients and optimize cost and quality outcomes via comprehensive care management, as well as APM development and management services.

“In the fee-for-service era, physician practice RCM was often treated as a back-office function with a predictable focus on increasing collections while minimizing denials,” said Dr. Charles Saunders, CEO of Integra Connect. “Value-based care has overturned that status quo. The practice revenue cycle now increasingly depends on the ability to optimize performance on care delivered to populations, with payment based on holistic value in terms of quality, experience and total cost. Integra Connect recognized that this would require a new kind of solution that aligns RCM processes directly with value-based payment methodology from the start.”

Integra Connect’s value-based RCM solution is now in deployment at multiple large practices nationwide and commercially available for specialists in urology and oncology.