Blog

Hospitals and health systems across the country are grappling with the financial impact of Covid-19. One critical strategy to combat lost revenue is to reduce out-of-network leakage. Understanding in real time where the leakage is occurring and developing strategies to bring the patients back into your own network can increase revenue, close quality care gaps, […]

Introduction Since March of 2020, the entire health care system supply chain has been disrupted due to the impact of the Covid-19 pandemic. Stay-at-home orders, unemployment and a surge of Covid-19 patients suppressed outpatient volumes, acutely altered payer mix and constrained hospital capacity. Fee-for-service (FFS) primary care was hit especially hard by this seismic shift […]

With all of the challenges that 2020 has injected into health system operations and priorities, providers and payers are appropriately focused on Covid-19 prevention and treatment, organizational preparedness and mitigation of financial impact. Texas providers participating in the Medicaid 1115 demonstration waiver Delivery System Reform Incentive Payment (DSRIP) also have a unique opportunity in the […]

The Centers for Medicare & Medicaid Services (CMS) has announced updates to the Medicare Shared Savings Program (Shared Savings Program) and Medicare Direct Contracting models due to the Covid-19 public health emergency (PHE), both of which require immediate action. These updates include an imminent deadline, as early as next month, for Shared Savings ACOs to […]

The Covid-19 public health crisis has had a substantial financial, economic, mental and physical health impact in the U.S. and around the world. Health systems and hospitals have had to increase hospital capacity, stop elective surgeries and adjust their workflows significantly to deal with the shifting needs of the community and patients serve. Outpatient and […]

During the 20th century, two world wars and numerous regional military conflicts claimed more than 150 million lives and decimated entire countries. During the past 100 years, trillions of dollars have been expended assembling armies and building military preparedness to defend homelands and protect the citizenry. However, it has taken less than three months for […]

Introduction The Covid-19 pandemic has created a barrier to health care at a magnitude the likes of which our industry has never seen. Many patients are terrified to receive care in traditional health care settings. There are abundant anecdotal accounts of patients suffering from heart attacks, strokes and other severe illnesses due to fear of […]

Health systems, hospitals and medical groups have had to significantly adjust to the continued financial impact of Covid-19. Payor contracting, including expectations under existing agreements, has taken on a new dimension because of emergency regulations, waivers, use of numerous technologies and other short-term accommodations. It is more important than ever to identify and act on […]

The Chinese saying, “Crisis equals opportunity,” may seem callous with relation to the Covid-19 pandemic; however, it is definitely apt. By most indications, the next several quarters, if not years, will be daunting for senior leaders, boards, and the health systems and hospitals they run, while at the same time creating new opportunities for those […]

Independent Physician/Provider Associations (IPAs) are key mechanisms for physicians, health systems and federally qualified health centers (FQHCs) to align and engage in value-based payment arrangements that add value to payors and attributed members. Here we discuss benefits to IPAs for engaging FQHCs and community-based organizations (CBOs) into their network, and care model and funds flow […]