ACOs: To Risk, Or Not To Risk?

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by Idette Elizondo, Manager; Amanda Brown, Senior Associate;
& Alexandra D'Innocenzo, Associate

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Despite many uncertainties, the shift toward value based payment continues. More Medicare Shared Savings Program (MSSP) ACOs have entered risk-based tracks (Tracks 2, 3, and now Track 1+), to take advantage of MACRA’s[1] 5% bonus to physicians in risk-based payment models. The latest numbers about exactly how many have selected risk for next year will […]

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Board Assessment for Hospitals & Systems: A Necessary Tool for Performance Improvement

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(Originally published in Nasdaq’s MarketInsite, July 18, 2017, and written on behalf of iProtean, now part of Veralon by Karma Bass, Principal, Via Healthcare Consulting)   “I don’t care about having a high-performing board.” It’s hard to imagine any CEO or board leader uttering these words in today’s rapidly changing healthcare industry. The stakes are just too […]

Posted in Governance, Virtual Board EducationTagged

OIG Reports on ACO Cost Savings and Quality Gains

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Over the first three years of the Medicare Shared Savings Program (2013-2015), 428 Accountable Care Organizations (ACOs) served 9.7 million beneficiaries. Most of these participating ACOs reduced Medicare spending compared to their benchmarks, resulting in a net spending reduction of nearly $1 billion, according to an August report from the Office of the Inspector General […]

Posted in Partnerships, M&A, and Finance, Quality, Virtual Board EducationTagged

Different Economics, Different Payment: Call Coverage Stipends for Employed vs. Independent Physicians

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Physician employment agreements now commonly include compensation for services beyond basic clinical services; they may also provide compensation for medical directorships, teaching, on-call payments, and so on. We have found that physicians transitioning to hospital employment are generally accepting of clinical compensation models that include a base salary coupled with productivity and quality incentives. However, […]

Posted in Healthcare Valuation, Provider Compensation

Tackling the IT Challenge in Your CIN

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by Molly Johnson, Manager & Alexandra D'Innocenzo, Associate

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Clinically Integrated Networks (CINs) need quality data to understand their patient population and manage provider practice patterns. That makes information technology (“IT”) critical at any stage of CIN development. For CINs with a mix of employed and independent physicians, IT is likely to be a tale of two cities – the employed physicians have solid, […]

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How to Handle Troublesome Behavior in the Boardroom

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Note: iProtean, now part of Veralon editorial staff will be on vacation through Labor Day. Look for the next blog/newsletter September 6.)   (From a recent interview with Karma Bass, Via Healthcare Consulting)   When fellow board members exhibit disruptive or troublesome behavior in the boardroom, they often don’t see it that way; that is, […]

Posted in Governance, Virtual Board EducationTagged

A Strategy for Post-Acute Care

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by Idette Elizondo, Manager & Amanda Brown, Senior Associate

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Hospitals and health systems have not historically focused on post-acute care. However, several factors are now motivating them to develop or strengthen their ties with post-acute care providers and establish an explicit post-acute care strategy. Acute care providers need to develop strong collaborative relationships with post-acute providers to ensure access to the post-acute care capacity […]

Posted in Strategy & Planning

Social Determinants of Health Gain Importance Through Population Health

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Economists estimate that 80 percent of all the cost of health care relate to social determinants of health. These include everything from exercise and healthy diet and healthy weight, to avoiding substance abuse and/or other self-destructive behaviors, to ensuring that people have adequate nutrition and housing. Those are big social issues that hospitals and health […]

Posted in Mission & Strategic Direction, Partnerships, M&A, and Finance, Virtual Board EducationTagged

Medical Staff Planning: A New Way to Think About Community Versus Hospital-Specific Needs

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by Rudd Kierstead, Principal

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Increasingly, hospital administrators are concluding that there is a great deal more to managing their employed physicians than simply signing them up. Hospital and health system leadership use data and analysis to create medical staff plans that determine the physician complement that best meets their various needs. Traditionally, hospitals and health systems have used two […]

Posted in Strategy & Planning