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 […]

Some Providers Tackle Food Insecurity as Part of Population Health Management

Economists estimate that two-thirds of all the cost of health care relates to what are called social determinants of health—those factors outside the acute care setting that affect health and cost. These factors include everything from exercise and healthy diet, healthy weight, to avoiding substance abuse or other self-destructive behaviors, to ensuring that people have […]

Experts Expect Senate to Significantly Change AHCA

On May 4 the House of Representatives passed a new version of the American Health Care Act (AHC) that made deep cuts to both Medicaid funding and marketplace subsidies. It now moves to the Senate, where experts predict it will undergo substantial changes.   Hospital groups opposed the newer version of the bill primarily because […]

Some Experts Predict Extension of MACRA Flexibility through 2018

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) determines only Medicare Part B payment, but hospitals and health systems will be affected through their employed and affiliated physicians. So those organizations are working to help their physicians succeed under the payment system, which will mean moving as quickly as possible to advanced alternative […]

Bundled Payments: Mandatory, Voluntary or Gone Altogether?

Policy experts recently weighed in on the future of the bundled payment program. Uncertainty has been the byword since the current administration delayed the start of the latest mandatory bundled payment program. Some have speculated that such models are “on their way out.” There is no consensus among experts.   A review of the background: […]

The Board’s Role in Cybersecurity

(Originally published in Nasdaq’s MarketInsite, March 30, 2017, and written by Gordon Clark, President and CEO of iProtean, now part of Veralon)   Cyberattacks. They are perhaps the most vexing security threats facing businesses today. To have a computer connected to the outside world is by definition to be vulnerable. Yet an analysis published in The NTT […]

MACRA and What It Means

(Excerpts from a presentation by Seth Edwards, Premier, Inc. at the iProtean, now part of Veralon Symposium, March 2017)   Helpful Acronyms and Definitions: MACRA: Medicare Access and Chip Reauthorization Act of 2015 QPP: Quality Payment Program—basically, a regulation that enacts the MACRA legislation MIPS: Merit-based Incentive Payment system—one of two tracks created under MACRA […]

MACRA and Medicare: Hospitals May Experience Large Payment Cuts

A study in Health Affairs’ April issue found that hospitals might experience larger-than expected Medicare payment cuts under the Medicare Access and CHIP Reauthorization Act (MACRA).   The report’s authors estimated that “MACRA will decrease Medicare spending on physician services by −$35 to −$106 billion (−2.3 percent to −7.1 percent) and change spending on hospital services by $32 […]

Uncompensated Care Still Causes Concerns for Providers

A major rating agency expects enrollment declines in the health exchange marketplaces created by the Affordable Care Act (ACA), thus increasing the level of uncompensated care for hospitals in 2018. Fitch Rating announced its prediction several days after the American Health Care Act (AHCA) was pulled from a planned March 24 vote in the U.S. […]