Threat of Cyber Attacks Requires Leadership Alignment

The threat from ransomware and other IT security challenges is expected to increase as hospitals acquire and hold ever-larger quantities of valuable patient electronic health records. The nature of the IT security threat changes so rapidly that ongoing education of hospital leaders is critical.   Hospitals have looked for effective ways to keep their leaders […]

Nontraditional Partnerships and Credit Ratings, Part 2

Nontraditional partnerships explicitly form to manage accountable care organizations and clinically integrated networks. Shared governance is typical in these types of partnerships. Other nontraditional partnerships include insurance companies, retailers and pharmacy companies.   Accountable care organizations and clinically integrated networks both collaborate among hospitals and physicians to manage large groups of patients to reduce the […]

How Nontraditional Partnerships Affect Hospitals’ Credit Ratings

In several of our courses we have covered the trend toward hospitals entering nontraditional businesses such as health insurance or retail operations as a means to absorb the impact of value-based reimbursement. Several of our experts have discussed mechanisms for such businesses: collaboration with existing companies, joint ventures with varying degrees of control, acquisition of […]

What’s Up With Insurance Mega-Mergers?

Amid speculation about the outcome, The Department of Justice (DOJ), joined by a number of states, filed complaints on July 21 in federal district court challenging the mergers of health insurance giants Anthem and Cigna and Aetna and Humana. Attorney General Loretta Lynch announced the filing and noted that these deals would eliminate competition at […]

Finance Experts Push Back on Proposed Payment Changes

Hospitals have been adding services to their outpatient departments in recent years as a means of reducing utilization in costlier inpatient settings as they move to population-based payment models. Medicare’s Outpatient Prospective Payment System (OPPS) proposed rule issued this week might negatively affect this trend, according to finance experts.   The proposed rule would disqualify […]

Recruiter Reports Surge in Physician Compensation

Physician movement and competition for top talent has caused an “upward spike” in physician payment, according to Merritt Hawkins, a healthcare recruitment firm. The firm’s data from April 1, 2015 to March 31, 2016 show a surge in compensation increases among 19 of 20 specialties it tracks.   Merritt Hawkins has conducted an annual review […]

Comments to CMS: MACRA Threatens Viability of Smaller ACOs

  Smaller accountable care organization (ACO) officials wrote comments to CMS noting that some provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) could hurt the viability of smaller ACOs.   The proposed rule, MACRA, will split physicians into those paid under the Merit-based Incentive Payment System (MIPS) and those paid annual […]

Final Rule Allows ACOs to Use Regional Benchmarks

CMS issued a final rule last week that will allow accountable care organizations (ACOs) to benchmark their results to regional Medicare spending, using a phased approach to incorporating regional fee-for-service (FFS) expenditures into calculations for resetting, adjusting, and updating an ACO’s rebased historical benchmark after an initial three-year agreement period.   National benchmarks will continue […]