Supercharging claims analysis capabilities empowers healthcare organizations to zero in on opportunities to improve care and reduce costs. The most successful organizations typically elevate their performance under value-based contracts by using claims analysis to drive engagement and improvement. Achieving next-level claims analysis status requires a multifaceted approach. To gain the most value from claims analysis, […]
There are signs that hospitals’ interest in employing physicians or owning physician practices may be waning—yet the need to align physicians with hospital strategy is perhaps greater than ever. American Medical Association (AMA) research shows that 33 percent of physicians were employed by hospitals or part of hospital-owned practices in 2016. That’s an increase of […]
Performance results were recently released for the 5th year of the Medicare Shared Savings Program (MSSP). These results show that a small but growing proportion of ACOs continue to earn shared savings from Medicare, as shown below. This data comes at a pivotal moment for Accountable Care Organizations (ACOs) as they rush to determine how […]
Veralon’s health system clients have achieved significant savings using Quanto to identify value-based improvement targets and provide the financial management reports to manage to those targets; client savings have varied from over $1 million to $13 million. Quanto was developed by Veralon and by Health Data Innovations, a leader in healthcare data integration. We partnered to make […]
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 […]
Although the final form of the tax bills in Congress has not been determined, it appears that discussion is progressing quickly. As it stands now, the final tax bill could affect not-for-profit and for-profit hospitals very differently, according to the Healthcare Financial Management Association. The Senate’s version of the bill would repeal the Affordable […]
CMS’s final rule for the Hospital Outpatient Prospective Payment System (OPPS) will increase overall 2018 hospital OPPS payment rates by 1.35 percent, according to a CMS fact sheet. However, hospitals are expected to see financial losses from Medicare payment changes related to drugs and knee replacements under the rule finalized this week. According to […]
Despite many uncertainties, the shift toward value based payment continues. More Medicare Shared Savings Program (MSSP) ACOs have entered risk-based tracks (Tracks 2, 3, and now Track 1+), to take advantage of MACRA’s[1] 5% bonus to physicians in risk-based payment models. The latest numbers about exactly how many have selected risk for next year will […]
Clinically Integrated Networks (CINs) need quality data to understand their patient population and manage provider practice patterns. That makes information technology (“IT”) critical at any stage of CIN development. For CINs with a mix of employed and independent physicians, IT is likely to be a tale of two cities – the employed physicians have solid, […]
Consolidation among healthcare providers has continued at a significant rate over the last decade. In 2005, 45% (2,220) of acute, non-federal community hospitals were independent; by 2015, the figure had fallen to 34% (1,677)[1]. Factors driving this consolidation have been well articulated and thoroughly examined, and include financial distress, competitive pressures, the challenges of success […]