Urgent care is one of the fastest-growing segments in health care, projected to grow almost 40 percent, to $18 billion, by 2017. Drivers include a projected increase in the insured population, a shortage of primary care physicians, the lower cost of urgent care compared with emergency department (ED) visits, and the potential of urgent care […]
If you are like many hospital finance leaders, you are probably still deciding how intensely you want to pursue the many new revenue models—such as ACOs, bundled payments, value-based payments, risk sharing. Even if you are undertaking the complex financial analysis of these contracts, along the lines described in the cover story for the April […]
New value-based payment models, including bundled payments and shared savings ACOs, will affect hospital and health system operating revenues and earnings (see “The Transition to Emerging Revenue Models,” hfm, April 2013). They will also create new demands for capital. It’s not about bricks and mortar; it is all about infrastructure requirements, working capital and […]
One of the biggest risks for healthcare CFOs right now is underestimating the extent to which payer contracting has become intertwined with every aspect of organizational strategy. Life was simpler in the old days. If a hospital CFO could negotiate substantial increases from private payers, and Medicare increases were reasonable, life was good. Sure, there […]
Hospitals have traditionally been unable to share savings with independent physicians for fear of setting off legal alarm bells—Stark, anti-kickback, and private inurement. This concept was so hardwired into the minds of health system executives that when some exceptions became possible through Medicare accountable care and bundled payment programs, everyone was skeptical. Now, the […]
Providers and valuators often are tasked with determining the fair market value (FMV) of employee compensation arrangements. Although each arrangement has unique issues, most valuation processes start by looking at quantitative measures. Creating a buttoned-up analysis supported by published benchmarks is relatively simple. However, qualitative factors also influence compensation FMV. The Quantitative Standard Using […]
With the first quarter of performance data released for Medicare’s Bundled Payment for Care Improvement (BPCI) initiative, participants are in one of two camps: relieved that they saved money, or wondering if they can really reduce costs of care in the area they selected. Among the organizations we have observed directly, all were able […]
John M. Harris and Idette Elizondo examine 2014 results from the Medicare Shared Savings Program and describe the key takeaways for current and prospective participants.
Results have come in for the first performance year of Medicare’s Bundled Payment for Care Improvement (BPCI) program. Providers are taking stock of successes and identifying areas for improvement.
John M. Harris and Carol Davis write that health systems need to develop strategies to respond to four specific types of disruptive innovators in health care.