When hospitals merge or enter into transactions, or a larger health system acquires a hospital, due diligence becomes a step to the process. During due diligence, an organization can “look under the hood,” if you will, and take a very deep dive into the operations of a hospital to identify any significant red flags that […]
Earlier this month, the Medicare Payment Advisory Commission (MedPAC) voted to cut reimbursement for some freestanding emergency rooms in urban areas. Industry analysts warned that the cuts could undermine access to care. Freestanding emergency departments receive Medicare payments equal to hospital emergency departments even though they have lower standby costs than on-campus emergency rooms, […]
Continuing with excerpts from recent interviews with our experts, Marian Jennings and Nate Kaufman talked about moving from volume to value, and what that means to them. Interviewer: What is Value? Nate Kaufman: Value relates to the fact that the benefits being provided are worth the cost. The question that a healthcare provider […]
Now that the iProtean, now part of Veralon Symposium has concluded and we have a rich source of new material from our experts for the upcoming courses, we will from time to time feature select abstracts from our experts’ interviews. Subscribers will see new courses such as Health Care: We Have a Problem; Doing More […]
The head of the U.S. Health and Human Services (HHS) said recently that the department will aggressively push to implement value-based payment, extending beyond ACOs and bundled payment initiatives. “ . . . we want to look at bold measures that will fundamentally reorient how Medicare and Medicaid pay for care and create a […]
Health experts have long argued that value-based payment would both improve quality and decrease/control healthcare costs. Now, five state governors have put into writing a set of policies and initiatives they believe could reduce the share of the economy consumed by health care. Value-based payment figures substantially into their “blueprint” for improving health care. […]
“Hospitals will face greater competition, risk of volume declines and margin erosion as the nation’s largest commercial health insurers aggressively pursue growth strategies that are aimed at lowering healthcare spending,” according to Moody’s Investors Service. Insurers’ strategies include: Acquisition of physician groups Acquisition of non-acute care services Tougher contract negotiations Greater restrictions on […]
Although written about widely in the last week, let’s recap how hospitals benefit under the budget deal signed into law on February 9. A two-year delay in cuts to Disproportionate Share Hospital payments Medicare payment extensions for rural providers Four additional years of funding for the Children’s Health Insurance Program Opioid addiction funding Repeal […]
The budget deal passed late last week establishes the ACO “Beneficiary Incentive Program,” said by some to motivate beneficiaries to be more engaged in their care. The program would allow ACOs to pay patients if they make primary-care appointments. The budget agreement also will allow beneficiaries to assign a physician in an ACO […]
Getting physicians on board with value-based payment models does not necessarily mean they are convinced of the efficacy of these models, according to a recent survey by Leavitt Partners. A summary of the survey results appears below: Only 20 percent of physician respondents said either bundled payments or hospital-led ACOs would contain healthcare costs. […]