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 […]
Medical staff development planning requires analytic rigor and detailed work. There is no way around it; a multi-hospital health system needs to determine the needs of each of its individual hospitals, as well as the system in the aggregate, in a consistent manner. Health systems can realize resource efficiencies and strategic benefits by addressing medical […]
CMS has opened applications for a second cohort of BPCI Advanced (Bundled Payment for Care Improvement-Advanced) participants in April. This initial application step gets you valuable data, and time to decide whether to pursue participation. Advantages of applying include: No obligation to participate. You have time (likely until fall 2019) to decide whether to sign […]
The greatest risk for health systems will be to assume that their leading role in health care is an immutable given. The strategic challenge will be to…
It’s tempting to short-change the due diligence process when acquiring a physician practice. In the heat of a deal, hospital leaders are understandably most interested in determining fair market value (FMV) so they can make the buy decision and set the purchase price. The due diligence process can turn up insights about a physician practice […]
Open PDF file > It’s healthcare’s version of dating: sizing up another organization for a potential partnership or merger. Seventy-one percent of healthcare leaders expect their organization’s merger, acquisition, or partnership activity to increase over the next three years. With continued changes to healthcare’s competitive landscape, hospital mergers and acquisitions (M&As) reached a record high […]
Karin Chernoff Kaplan review the basics – and the importance of – establishing consistent processes for setting up and managing physician compensation agreements and thresholds that avoid regulatory problems.
It’s one thing to sit down with a payer and negotiate incentivized goals in a value-based payment contract. It’s a different thing entirely to change the behavior of the practitioners in your medical group in order to meet those goals. Physicians who choose to sell their practice and become employees are typically relieved to […]