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Webinar: Designing for Dignity: Disrupt Workforce

February 22, 2023

The speakers at the “Designing for Dignity: Disrupt Workforce” webinar will take juicy, creative, human-centered innovation and make novel solutions succeed out there in the real world. This webinar will help us learn how provider systems and consultants are tackling strategy, analysis, and financial modeling as generative design tools, and help organizations turn their biggest, […]

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What Payers and Providers Should Know About Proposed Changes to Medicare Advantage

February 13, 2023

On February 1st, CMS released the 2024 Medicare Advantage and Part D Advance Notice to inform Medicare Advantage organizations of proposed changes to the program. The changes that were proposed in that notice stretch far beyond just Medicare Advantage organizations (MAOs). Providers serving Medicare Advantage members in value-based arrangements will also be impacted and in […]

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5 Key Considerations for Your REACH ACO’s Health Equity Plan

January 12, 2023

In late December 2022, CMS published the ACO REACH Health Equity Plan Templates, Guide and FAQ, outlining the standards and requirements REACH ACOs must meet in their efforts to address targeted health disparities in underserved communities in their service area. Health Equity is a hallmark ACO REACH initiative and a significant differentiator between the program […]

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2023 Health Care Forecast, Trends and Key Issues

January 6, 2023

1. Continued transition to more value-based payment and risk for all lines of business: Payers partnering to create more collaborative platforms and relationships with providers Focus on improving outcomes and support strategies to mutually gain market share while leveraging value-based payment arrangements Providers realizing the need to develop a clear strategy and goals for […]

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5 Considerations of the ACO REACH Model Performance Period Participation Agreement

December 13, 2022

CMS has released the final ACO REACH Model Performance Period Participation Agreement (MPP PA) for PY2023 starters as well as a redlined version of the MPP PA compared to the GPDC Model Performance Period PA for PY2022 starters that highlights the updates made to the PA. Here are the key five considerations every ACO entity […]

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Clinical Continuity Improvement

November 16, 2022

Background: Our client is a large Academic Medical Center located in the Northeast with a direct-to-employer contract managing a commercial employee population. The health system uses Analytics for Risk Contracting (ARC) and the COPE Health Solutions (CHS) Data Analytics as a Service (DaaS) solution to identify specific opportunities and track performance in specific aspects […]

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Payer/Provider Partnership

November 16, 2022

Background: Hawaii Health Network (HHN), based in O’ahu, HI, is a recently formed Clinically Integrated Network (CIN) composed of four partner medical groups/IPAs and is the state’s largest post-acute care provider. HHN’s mission is to be a clinically integrated network that systematically supports independent physicians and provides others in the transition from volume to […]

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CIN/IPA MSO Co-Source

November 16, 2022

Background: Our MSO Co-Source client is a provider-led health system, physician governed clinically integrated network (CIN), and independent physician association (IPA) in the Northeast. The IPA is committed to enabling network providers to successfully perform in value-based payment (VBP) contracts with payers through strategic collaboration, powerful data & analytics, enhanced provider engagement strategies and […]

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Building a Primary Care Network to Support Your Organization in Value-based Care

October 5, 2022

As medical groups, health systems and health plans across the U.S. continue to feel the impact of COVID-19 and the Great Resignation, many are struggling to build sustainable pipelines of qualified staff and providers. Physician burnout, retirement and inflation are all factors leading individuals to leave the profession and/or retire. Recent studies have indicated that […]

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California Continues to Shape Payer & Provider Alignment to Address Social Drivers of Health & Health Equity

September 8, 2022

With the heaviest burdens of the pandemic falling disproportionately on Californians who are low-income Black and Latino and on frontline workers, the need to implement targeted solutions to address long-standing Social Drivers of Health (SDoH) and health equity is at an all-time high. This is reinforced by the principles and goals of California’s newest Medicaid […]

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