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 […]
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 […]
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 […]
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 […]
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…
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 […]
Proactive collaboration allows AMCs and community counterparts to benefit from each other’s strengths, creating value that wasn’t necessarily sought or derived from more traditional partnering approaches. In Part I of this blog post on partnerships between community hospitals/systems and academic/major teaching centers (“AMCs”) we: Explored changes in AMC rationale for pursuing partnerships and partner attributes […]
Industry transformation requires major adaptations from healthcare organizations – to increase scale, enhance scope, and achieve differentiation, among others. Partnerships can be a key vehicle to facilitate and pursue these adaptations. Partnerships between academic and community hospitals/health systems are a unique sub-set of healthcare provider partnerships. Academic providers aligning with their community counterparts is, of […]
