One Size Does Not Fit All: Your Ambulatory Services Must Be Tailored to the Value Equation of Each Consumer Segment

by Mark J. Dubow, Director
and Ross Shuster, Senior Associate

If your ambulatory network is the only provider in town, and it is providing high-quality services at reasonable rates that meet the community’s needs, those characteristics will likely position your organization for success. But what happens when your organization is surrounded by competitors (including some of the new entrants) fighting for market share? How do […]

Physician Engagement in Employed Physician Enterprises: Going Deeper

by Rudd Kierstead, Principal

You want to reduce physician subsidies in your employed physician enterprise, and you have numerous initiatives to increase physician engagement under way. What matters, however, is not the number of physician engagement efforts, but how thoroughly they engage physicians in operations at the ground level. Veralon recently surveyed leadership at 30 physician enterprises with 11,000 […]

Micro-Hospitals: Short-Term Fad or Promising Market Growth Strategy?

by Meredith Inniger, Manager

Many conversations we have with hospital and health system executives about market growth strategies eventually turns to the topic of micro-hospitals — and for good reason. These facilities typically include a small-scale emergency department (ED), low-acuity surgery, and are often comprised of eight to 10 inpatient beds as well as additional observation beds (notably, these […]

Coordinated Medical Staff Development Planning for Large Health Systems

by Robert Hill, MBA, MS, FACHE and Craig E. Holm, MBA, FACHE

Medical staff development planning requires analytic rigor and detailed work. There is no way around it; a multi-hospital health system needs to determine the needs of each of its individual hospitals, as well as the system in the aggregate, in a consistent manner. Health systems can realize resource efficiencies and strategic benefits by addressing medical […]

Evaluating the Financial Performance of Your Employed Physician Enterprise: Going Beyond Physician Losses

by Rudd Kierstead, Principal and Craig E. Holm, Director

If your employed physician enterprise is like most, you are experiencing calculated losses of $100,000 to $200,000 per physician, and the losses are likely increasingly intolerable. The figures for physician losses, as currently determined, certainly grab attention, and as a financial indicator are very important. However, those figures do not provide much in the way […]

BPCI Advanced: Apply Now,
Decide Later

by Amanda Brown, Manager, and Amanda Kueh, Analyst

CMS has opened applications for a second cohort of BPCI Advanced (Bundled Payment for Care Improvement-Advanced) participants in April. This initial application step gets you valuable data, and time to decide whether to pursue participation. Advantages of applying include: No obligation to participate. You have time (likely until fall 2019) to decide whether to sign […]

Advanced Practice Clinicians in Medical Staff Planning: Four Factors to Consider

by Molly Johnson, MHSA and Craig Holm, MBA, FACHE

The growth and aging of the U.S. population will significantly increase the demand for medical care over the coming decade. At the same time, the supply of physician services is decreasing as physicians work fewer hours per week, and retirements are likely as more than a third of currently active physicians reach age 65 within […]

ACO Pathways to Success: Final Rule Softens Impact

by Amanda Brown and John Harris

CMS published its final rule, the “Pathways to Success” for the Medicare Shared Savings Program, in December 2018. CMS’ overall goal is clear and unchanged from the proposed rule: to put the “accountability” back in accountable care by moving ACOs more quickly to downside risk. While the final rule tracks the proposed rule issued in […]

To Merge or Not to Merge: Informing the Conversation

by Scott Stuecher and Daniel Grauman

“Everyone in the industry is merging. We should be too.” “We’ve always been independent, and we should stay that way.” Independent hospitals continue to merge or affiliate with other hospitals or with health systems. However, independent hospitals still have company. In 2016, the latest year for which information is available, there were about 1,600 independent […]

6 Big Changes in Proposed ACO Regulations

by John Harris, Director & Molly Johnson, Manager

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On August 9, 2018, CMS issued new proposed regulations for MSSP ACOs that, if finalized, will result in far-reaching changes in the program. The motivation for the proposed changes, which CMS calls “Pathways to Success,” is simple: CMS wants to move ACOs to risk more quickly. The great majority of 2018 participating ACOs are not […]