As health system physician enterprises have grown, addressing their challenges are central to health system success. Engaging physicians and supporting health system goals requires a cohesive approach. Contact the Experts: Mark Dubow, Director, mdubow@veralon.com Rudd Kierstead, Principal, rkierstead@veralon.com
Do you have a CIN? Is it achieving what it should? Contact the Authors: John Harris, Managing Director, jharris@veralon.com Molly Johnson, Manager, mjohnson@veralon.com
Shifting a $1 trillion dollar industry from confidential contracts to publicly published pricing is a massive transformation. In the middle of recovering from the COVID-19 crisis, hospitals are responding to this transformation. Background: The hospital price transparency rules require consumer-friendly tools to help individuals shop for hospital services based on price. They also require hospitals […]
By recategorizing procedures previously designated inpatient only, CMS is actively redirecting a significant number of cases to Hospital Outpatient Department (“HOPD”) and community-based ambulatory surgery center (“ASC”) settings. We have discussed the impact this will have on outpatient surgery, and strategies to prepare. This outpatient shift will also affect cardiac services, creating both risks and […]
Rapid evolution in diagnostics and treatment for cancer care, innovation through genomics and predictive analytics, the continuing shift toward value-based care are hastening the migration of oncology from hospital settings to community-based centers. This raises the question: Is now the right time to invest in a community oncology center? The experiences of multiple health systems […]
Surgery has long been a key driver of hospital profitability. Effectively handling the new Medicare outpatient surgery rule[1] and subsequent care shift to outpatient settings is critical to long term financial success. This rule includes several important policy changes, most notably the elimination of the Inpatient Only List on a phased schedule through CY2024 when […]
Many independent physicians are financially challenged as the COVID-19 impact continues. Some may find employment or other alignment opportunities attractive now, even if they have not shown interest in the past. Health systems that work to develop relationships with these physicians now will be at an advantage.
CMS continues to authorize voluntary and mandatory alternative payment models (APMs) to shift risk to providers. Beyond choosing which models offer the best opportunity, providers must evaluate the impact of participating in multiple APMs simultaneously. Overlapping APMs can be synergistic or self-defeating. Where simultaneous participation is an option, overlapping incentives are complicated and may not […]
Even before the pandemic, the median loss per physician employed by a hospital or health system totaled more than $278,000. Now, as hospitals face their biggest financial crisis ever, hospital leaders must consider: “Is there a better structure for our physician enterprise?” The pain points that hospitals and physicians experience under an employed physician enterprise […]
Your organization’s near-term success is dependent on emerging from COVID in full sprint to address critical strategic initiatives and new opportunities. Strategic relationships can provide access to capabilities, expertise and speed to market that are superior to a “build” or “buy” approach. While traditional relationships (other hospitals/systems, health plans, etc.) offer a degree of support, […]