The COVID-19 crisis is likely to include a series of recurring cycles over an extended period —a “pulsed recovery” that will result in a new normal in which clinical care operations have fundamentally changed. While Herculean efforts are focused on the immediate challenges, the deferred needs of the chronically ill (e.g., congestive heart failure, COPD, […]
Many physicians, and other clinicians, are working harder than perhaps they ever have under extraordinary conditions, as COVID-19 surges through our communities. While those conditions will improve as the initial surge subsides, physician practices, both independent and employed, will need to change to respond to the consequences of that surge, and the potential for secondary […]
COVID-19 is a tsunami for hospitals—the waters pulling back as beds are emptied, then an overwhelming and uncontrollable surge wave. Like an actual tsunami, this one may have multiple surges. But even with several waves, an actual tsunami is over quickly and recovery returns you to a former baseline. With COVID, it is likely that […]
The Blanket Waivers that CMS issued on sanctions under the physician self-referral law (Stark) do not halt application of the law during this emergency time period. Instead, they waive sanctions for certain circumstances that would otherwise violate the self-referral law. The 18 individual waivers address a variety of financial arrangements between physicians and designated health […]
Covid-19: A prediction challenge like no other Covid-19 will challenge hospital leaders in many ways. But no one expected that a key challenge would be in a basic skill every hospital administrator mastered early in their career – estimating volume. Hospital leaders are accustomed to estimating volume. They do it all the time – for […]
Ambulatory care has grown dramatically in recent years, and all signs point to continued growth. In 2017 (the most recent year for which data is available), net outpatient service revenue equaled 95% of net inpatient revenue, an increase from 83% in 2013.[1] Clearly every hospital and health system must have an effective ambulatory care strategy. […]
What is the Primary Care First Program (PCF)? PCF is a voluntary 5-year CMS Advanced Alternative Payment Model (APM) with two care models—one for “Advanced” primary care and one for high-need, seriously ill Medicare beneficiaries (Seriously Ill Population, or SIP). The latter is aimed primarily at providers who typically provide hospice or palliative services. Practices […]
If your ambulatory network is the only provider in town, and it is providing high-quality services at reasonable rates that meet the community’s needs, those characteristics will likely position your organization for success. But what happens when your organization is surrounded by competitors (including some of the new entrants) fighting for market share? How do […]
Healthcare megamergers are picking up steam, with the merger of Aurora Health Care and Advocate Health Care completed in 2018 and the merger of Catholic Health Initiatives and Dignity Health (now CommonSpirit Health) finalized earlier this year. Optum also completed their acquisition of DaVita Medical Group in June of this year. It’s a trend that […]
You want to reduce physician subsidies in your employed physician enterprise, and you have numerous initiatives to increase physician engagement under way. What matters, however, is not the number of physician engagement efforts, but how thoroughly they engage physicians in operations at the ground level. Veralon recently surveyed leadership at 30 physician enterprises with 11,000 […]