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 […]
Medicare payments to hospitals under the inpatient prospective payment system (IPPS) will increase by about $2.4 billion in fiscal year (FY) 2018 under final rule CMS issued August 2. The increase is less than the $3.1 billion anticipated under the proposed rule released in April. The rule will take effect October 1. In its […]
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 […]
(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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
. . . just a brief newsletter/blog this holiday week. The Congressional Budget Office (CB)) assessment of the new American Health Care Act is in. Some highlights include: Reduction of federal deficit by $119 billion 23 million people would be added to the ranks of the uninsured by 2026 Savings from reductions in […]