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Hospitals, state associations and other stakeholders need to be prepared to address the negative financial impacts associated with the COVID-19 pandemic as it continues to have a widespread impact on our health care system. Many hospitals are likely to experience severe financial challenges, requiring financial assistance from federal, state and local governments in order to […]

On March 22, 2020, the Centers for Medicare and Medicaid Services (CMS) offered some relief for the clinicians, providers, and facilities participating in Medicare quality reporting programs – including the 1.2 million clinicians in the Quality Payment Program and those fighting coronavirus (COVID-19). This unprecedented action by CMS has been applauded by the American Medical […]

Innovation in health information technology, coupled with challenges presented by the COVID-19 pandemic, provides an opportunity for hospitals and health systems to use telemedicine to support patient care. Health care organizations can use two complementary types of telemedicine to staff shortages and keep patients away from the hospital during this public health emergency: episodic telehealth […]

Desperate Times Call for Desperate Measures In merely days, COVID-19 evolved from an international concern to a national emergency here in the United States. As of March 23, 2020, over 38,000 community-acquired cases have been confirmed nationwide, amidst very limited testing. Public health officials and hospital administrators across the country are on high alert, frantically […]

On March 13, 2020, President Donald Trump declared a national emergency over the novel coronavirus, making $50 billion available for aid. This includes a requirement for all hospitals to enact their emergency preparedness/operations plans while lifting some regulatory barriers to care delivery that might impede successful crisis response. This crisis triggers a cascade of activities […]

An influential nonprofit hospital critic, Republican Chairman of the Senate Finance Committee Chuck Grassley, asked the IRS in 2019 to probe whether the hospitals are living up to their charitable obligations.1 Senator Grassley helped enact requirements included in the Affordable Care Act and set standards for nonprofit hospitals and information they’re required to disclose. Nonprofit hospitals are […]

The survey commissioned by Change Healthcare and HealthCare Executive Group and conducted by InsightDynamo provides some excellent insights. It is interesting to see where payors and providers in the study align and where they differ. Here are the key takeaways:   “Alternative payment models” is a term that applies to a broad range of reimbursement […]

Introduction Social determinants of health (SDOH) can play a major role in ensuring better health outcomes at both the individual and population level. SDOH are responsible for over 80 percent of health outcomes while clinical interventions represent only 20 percent1. While the impacts of SDOH are well known, many providers and organizations still do not […]

This is part one of a series of articles focused on FQHCs and FQHC Look-Alikes. These community health centers can play a critical role in managing population health and achieving success in value-based contracts. Many communities struggle with access to high quality primary care services for their residents with lower incomes. Language and cultural barriers […]

The State of California is “carving out” the pharmacy benefit for Medi-Cal beneficiaries from managed-care plans and transitioning to a fee-for-service (FFS) program, moving 13 million Medi-Cal beneficiaries to a new pharmacy program by January 2021. Medi-Cal is taking responsibility from the managed care organizations (MCOs) for one of the key elements of care, the […]