Hospital systems and health insurers have very different financing structures. Hospital boards and executive management will want to consider the fundamental differences when considering whether to combine both organizations within the same larger health system. Briefly, the health system has these fundamental financial structure characteristics: Significant physical plant investment Fewer growth opportunities Higher margins, […]
Veralon Views Blog
The Veralon Views blog is an extension of our partnership with leaders who are transforming the healthcare industry. Here, we share expert perspectives from our nationally recognized senior consulting team on issues that are key to the success of your organization.
A strategic plan provides a roadmap for where a hospital or health system will focus its efforts and resources. The plan must generate financial results required for long term success. Therefore, financial implications should be integrated throughout the planning process to focus on the initiatives that will have the most profound positive impact on the […]
Hospital inpatient drug costs have been rising and this will continue, but at a moderate pace due to public scrutiny of pharmaceutical companies’ drug pricing practices. Moody’s noted in a recent article that even at a slower rate of growth, “we expect rising drug costs will continue to challenge hospitals’ financial flexibility.” (“Not-for-profit and public […]
(The following is an excerpt from “Different Economics, Different Payment: Call Coverage Stipends for Employed vs. Independent Physicians,” Veralon INSIGHTS, September 2017. Dan Grauman, one of our expert presenters, is the Managing Director and CEO of Veralon Healthcare Management Advisors. For the full article, please see the link below.) “Physician employment agreements now commonly […]
Reporting and collecting data for 2017 for the Merit-based Incentive Payment System (MIPS) should be underway in provider organizations. But some may have decided to wait because of what they perceive as high administrative and labor costs. According to experts, these organizations “are well advised to take a closer look at the potential benefits and […]
by Idette Elizondo, Manager; Amanda Brown, Senior Associate;
& Alexandra D'Innocenzo, Associate
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& Alexandra D'Innocenzo, Associate
Open PDF file >
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 […]
(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 […]
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 […]
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, […]
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, […]