Blog
Optimizing an ACO Network to Succeed in Downside Risk Arrangements
June 21, 2018Recent announcements from the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) indicate that the current administration sees cost savings opportunities when providers, including hospitals, take downside financial risk. HHS Secretary Alex Azar commented, “There is no turning back to an unsustainable system that pays for procedures […]
Golden State Guidepost – A Preview of Operational Financial and Regulatory Dilemmas
June 15, 2018 Read moreHeads You Win, Tails You Win – Roadmap to a Win-Win Path to Downside Risk in Medicare Alternative Payment Models
June 6, 2018ACOs that started in the Medicare Shared Savings Program’s Track 1 in either 2012 or 2013 must determine whether to move to a risk-based model by their third contract periods, which begin in 20191. A number of the MSSP ACOs are making strides in improving quality, reducing hospitalization and waste in Medicare. The Centers for […]
Fee-For-Service to Value-Based Payment Transformation Part 3: Bearing Financial Risk in a Changing Landscape: Are You Ready? Part B
June 5, 2018 Read moreCalifornia Delegated IPAs and Medical Groups: Operational, Financial and Regulatory Dilemmas
April 16, 2018Delegated IPAs and medical groups in California provide valuable health care services to millions of Medi-Cal Managed Care, Medicare Advantage and Commercial Health Maintenance Organization (HMO) members. These “pioneer” providers practiced population health management before it gained industry currency and have utilized outcomes-based payment to incentivize provider innovation for decades. Risk-bearing medical groups and IPAs […]
Supporting Transformation through Delivery System Reform Incentive Payment Programs: Lessons from New York State
March 27, 2018 Read moreCare Navigators Offer Cost-Effective Solution for Improving Value-Based Care
March 7, 2018 Read moreImproving Post-Discharge Phone Call Rates Using Health Scholars
February 8, 2018Background: Benefits of a Post-Discharge Phone Program Hospitals have improved patient outcomes and patient satisfaction scores via implementation of a successful post-discharge phone call program to achieve: Improved patient outcomes: Patients receiving a post-discharge call were 23.1% less likely to be readmitted compared to patients who did not receive a call1. Early detection of adverse […]
Key Trends in 2018 for Health Care Organizations Moving to Value-based Payment and Population Health Management
February 3, 2018Health care is in a tumultuous time and what’s for certain is that nothing is for certain. The passing of the recent Tax Cuts and Jobs Act of 2017 (TCJA) has broad but still not completely understood implications for the business community and economy, including non-profit health hospitals and health care systems, generally adding more […]