What CMS bundled payment initiative are we on? It can be hard to keep track. First there was the Bundled Payments for Care Improvement (“BPCI”) model, a voluntary bundled payment program beginning in 2013. Then in 2016, CMS introduced the CJR (Comprehensive Joint Replacement) bundled payment model, which was initially mandatory in 67 MSAs […]
Accountable Care Organizations (“ACOs”) receive a substantial portion of their revenue through shared savings programs in which payers pay the ACO a portion of total cost savings generated by member providers through effective care management. The ACOs then distribute part of the shared savings to participating healthcare providers, based on a distribution formula; the remainder […]
Healthcare Strategic Planning, Fifth Edition provides guidance for every stage of strategic planning and implementation: analyzing the environment, crafting strategy, putting the plan into action, and assessing the results. It describes the crucial decisions that must be made and the preparatory steps that must be taken for effective planning. This new edition contains the most recent […]
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, […]
CMS wants more physicians to participate in ACOs and other alternative payment models (APMs). It’s best if they are risk-taking ACOs, but any ACO seems to be better than none. At least, that is what the incentives in MACRA seem to indicate. Prior to the passage of MACRA (the Medicare Access and CHIP Reauthorization Act […]
John M. Harris and Craig E. Holm describe howimplementation of MACRA bring significant strategic implications for hospitals and health systems as well and physicians.
Physician engagement is critical to CIN success. True engagement, however, takes vigilance and a long-term commitment; having physicians join your network is just the beginning of the process. Our experience has shown that, despite their best intentions, many CINs lose touch with their physician membership at some point along the road. Effectively engaging physicians in […]
Accountable care organizations are at the forefront of the healthcare industry’s transition to value-based care; those that succeed will provide a leading example for the industry to follow.
