No Medicaid lifetime limits and a hard stance on ACO risk contracts highlighted CMS head Seema Verma’s talk at the American Hospital Association’s recent annual meeting. “We’re determined to make sure that Medicaid remains the safety net for those who need it most,” Verma said. “To that end, we have determined we will not approve […]
As the healthcare market expands and evolves, the inherent risks also are increasing. These risks include: The shift from volume to value The rise of the consumer and expansion of consumer options New payment models Mobile strategies New entrants An aging population Continued political and regulatory uncertainty Whereas hospitals/systems have traditionally done well at […]
A high volume of mergers and acquisitions between and among hospitals and health systems continue to dominate the healthcare landscape, with an increasing number of transactions anticipated in 2018.1 The benefits of consolidation are well known: Enhanced access to care and increased market share by providing specialty or subspecialty physician coverage previously unavailable or by […]
Earlier this month, the Medicare Payment Advisory Commission (MedPAC) voted to cut reimbursement for some freestanding emergency rooms in urban areas. Industry analysts warned that the cuts could undermine access to care. Freestanding emergency departments receive Medicare payments equal to hospital emergency departments even though they have lower standby costs than on-campus emergency rooms, […]
Continuing with excerpts from recent interviews with our experts, Marian Jennings and Nate Kaufman talked about moving from volume to value, and what that means to them. Interviewer: What is Value? Nate Kaufman: Value relates to the fact that the benefits being provided are worth the cost. The question that a healthcare provider […]
Now that the iProtean, now part of Veralon Symposium has concluded and we have a rich source of new material from our experts for the upcoming courses, we will from time to time feature select abstracts from our experts’ interviews. Subscribers will see new courses such as Health Care: We Have a Problem; Doing More […]
The head of the U.S. Health and Human Services (HHS) said recently that the department will aggressively push to implement value-based payment, extending beyond ACOs and bundled payment initiatives. “ . . . we want to look at bold measures that will fundamentally reorient how Medicare and Medicaid pay for care and create a […]
Health experts have long argued that value-based payment would both improve quality and decrease/control healthcare costs. Now, five state governors have put into writing a set of policies and initiatives they believe could reduce the share of the economy consumed by health care. Value-based payment figures substantially into their “blueprint” for improving health care. […]
“Hospitals will face greater competition, risk of volume declines and margin erosion as the nation’s largest commercial health insurers aggressively pursue growth strategies that are aimed at lowering healthcare spending,” according to Moody’s Investors Service. Insurers’ strategies include: Acquisition of physician groups Acquisition of non-acute care services Tougher contract negotiations Greater restrictions on […]
Although written about widely in the last week, let’s recap how hospitals benefit under the budget deal signed into law on February 9. A two-year delay in cuts to Disproportionate Share Hospital payments Medicare payment extensions for rural providers Four additional years of funding for the Children’s Health Insurance Program Opioid addiction funding Repeal […]