MACRA Made Simple

(The following includes excerpts from our upcoming course, Strategic Issues for Boards, as well as information that didn’t make the cut.)   MACRA creates two different tracks for clinicians to participate in Medicare. One is called the Merit-Based Incentive Payment System, or MIPS. The second is the Advanced Alternative Payment Model (AAPM). Each of these […]

Elements for Defense Against Information Breaches

To protect against cyber attacks, an organization should have an enterprise risk management program that has three layers of defense: information security, internal audit and risk management. These layers complement one another.   The information security group has a large swath of IT related issues to cover. The internal audit group will help the information […]

Due Diligence: Not All Risks Are Equal

by Danielle Bangs, Manager and Benjamin Tudor, Associate

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A prudently conducted due diligence effort will surface a comprehensive (and often lengthy) list of potential risks and issues related to the transaction being assessed. However, the implications of these risks will vary widely. In the thick of due diligence, it often seems that finding issues and risks is the ultimate goal. It can be […]

Survey Shows Lack of Knowledge About MACRA

About half of hospital-based physicians said they were not knowledgeable about the Medicare physician pay overhaul (Medicare Access and CHIP Reauthorization Act of 2015—MACRA) that began earlier this year, according to a recent survey by KPMG and the American Medical Association. This represents a larger share compared with physicians in other settings.   The survey […]

HFMA: Preparing for New Bundled Payments Part 2

Last week we covered the first four elements for structuring cardiac payment bundles. These included establishing clear and achievable goals, focusing on inpatient costs and reducing care variations, being guided by data and focusing on medication management and compliance.   The remaining three elements are:   Reorganize to manage post-acute spending. Effective cost management requires a […]

HFMA: Preparing for Cardiac Bundled Payments Part 1

Approximately 2,440 hospitals will participate in the bundled payment program for cardiac care beginning in January 2018. Health systems around the country have identified essential steps for structuring cardiac bundle programs to optimize performance, according to a recent report from the Healthcare Financial Management Association.   Of the 2,440 hospitals that will participate, 1,120 in […]

Moody’s: NFP Hospitals Should Focus on Risk Management

The ability to implement effective strategies to minimize risk will become increasingly important in determining not-for-profit and public hospitals’ credit strength in the changing landscape. These hospitals are focused on risk management to avoid pitfalls and capitalize on new opportunities in anticipation of momentous changes, not the least of which is the fate of the […]

AHCA Medicaid Rollback Concerns Provider-Sponsored Plans

Under the House’s updated version of the American Health Care Act (AHCA), provider-sponsored plans expect decreased federal funding resulting in many of the people they cover becoming uninsured, and also hospital closures.   For example, one CEO of a provider-sponsored plan said recently at a not-for-profit healthcare investor conference, “The AHCA scares the hell out […]

4 Ways to Simplify — and Strengthen — Your Physician Compensation Plan

by Stuart J. Schaff, Senior Manager, and Amanda Brown, Senior Associate

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Can your physicians easily project their compensation for the next year with reasonable accuracy, or do they need to have their accountants build elaborate Excel models to do so? Many hospitals and medical practices have made their physician compensation plans more intricate as healthcare has become more complex. However, compensation plans that are too complicated […]