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 […]
Physicians who generate significant income from procedural or technical/ancillary components of their practice have understandable concerns that an employment relationship with a health system or hospital will not be financially attractive. They realize that employment could mean losing the income from their usually profitable procedures and technical components, and so are uninterested in having their […]
Experts already predict another record-breaking year for private equity investment in physician practices, with 45 deals announced or closed in Q1 2019 alone. As private equity interest in ophthalmology and dermatology stays hot, and as other specialties capture investors’ attention and dollars, some health system leaders are offering an alternative to private equity capital by […]
Many conversations we have with hospital and health system executives about market growth strategies eventually turns to the topic of micro-hospitals — and for good reason. These facilities typically include a small-scale emergency department (ED), low-acuity surgery, and are often comprised of eight to 10 inpatient beds as well as additional observation beds (notably, these […]
The move toward value-based contracts is happening “in small doses,” a 2018 MGMA survey found. While nearly three out of five hospitals participate in value-based contracts, just 34 percent of healthcare reimbursement is tied to value. This presents healthcare leaders with a dilemma: How can we engage physicians in value-based payment models when so little […]
The use of CPT code modifiers to adjust work relative value units (wRVUs) under physician compensation models has become a universal practice among hospitals and health systems that employ physicians—and with good reason. The risks of not applying CPT code modifiers—such as an inability to objectively measure performance—are significant. Why should healthcare organizations that employ […]