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 […]
“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 […]
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 […]
As hospitals and health systems build their employed medical practices, a large emphasis is often put on compensation arrangements, and little attention is paid to engaging physicians in the successful management of these practices. At the same time, hospitals are experiencing significant operating losses for their employed practices. Losses vary, but hospital-owned practices typically lose […]
Twelve years after launching the retail health insurgency with the purchase of the start-up MinuteClinic, CVS Health is upping the ante. In the biggest deal of 2017, CVS Health acquired Aetna in December. At this point, all predictions about how this merger will impact hospitals and health systems are conjecture. However, hospital leaders would be […]
Advanced practice clinicians are sometimes casually thought of as a cheaper alternative to physicians by healthcare administrators. In actuality, there are many compelling reasons to bring these clinicians into a practice; economics is not the whole picture. Many high-performing practices have found that advanced practice clinicians (APCs), including nurse practitioners (NPs), physician assistants (PAs), and […]
If your organization is like most health systems and hospitals, your physician recruitment plan may be based on a less than complete picture of your existing physician base. Many medical staff recruitment plans do not consider the extent to which the organization’s physicians and their patients are making use of the organizations inpatient and ambulatory […]
A strategic plan provides a roadmap for where a hospital or health system will focus its efforts and resources. The plan must generate financial results required for long term success. Therefore, financial implications should be integrated throughout the planning process to focus on the initiatives that will have the most profound positive impact on the […]
Hospitals and health systems have not historically focused on post-acute care. However, several factors are now motivating them to develop or strengthen their ties with post-acute care providers and establish an explicit post-acute care strategy. Acute care providers need to develop strong collaborative relationships with post-acute providers to ensure access to the post-acute care capacity […]
Increasingly, hospital administrators are concluding that there is a great deal more to managing their employed physicians than simply signing them up. Hospital and health system leadership use data and analysis to create medical staff plans that determine the physician complement that best meets their various needs. Traditionally, hospitals and health systems have used two […]