Moody’s Investors Service 2017 Outlook for not-for-profit and public healthcare predicts stability over the next 12 to 18 months. Its analysts base projections on 0 to 1 percent operating cash flow growth and solid patient volume and revenue growth. Technology and operational investments, however, will continue to bring pressure on hospitals and systems. […]
Despite the attention being given to potential repeal of the Accountable Care Act, we can be reasonably certain that some aspects of health care reform are unlikely to be overhauled anytime soon—or possibly, at all. Among these is the shift to and emphasis on value-based payment, with its focus on providing high quality care in […]
Expecting significant movement to repeal and replace the Affordable Care Act (ACA) early in the next Administration, financial analysts have expressed concern that the proposed changes to Medicaid are likely to have the largest financial impact on hospitals. Since implementation, the ACA marketplaces/exchanges have garnered more media coverage, but hospitals saw more activity from those […]
Many questions have arisen about the future of the Affordable Care Act (ACA) since the election. From providers’ point of view, iProtean expert and Veralon Managing Director and CEO Dan Grauman noted the “repeal” of ACA probably will not eliminate alternative payment models (ACOs, bundled payments, etc.). Grauman noted in a recent update that […]
CMS estimates that the hospital value-based purchasing program (VBP) will have approximately $1.8 billion dollars for value-based incentive payments for FY 2017 hospital discharges. The incentive pool is funded by reducing the base operating Medicare Severity diagnosis-related group (MS-DRG) payment amounts that determine the Medicare payment for each hospital inpatient discharge. For fiscal year […]
CMS will reopen applications for new practices and payers in the Comprehensive Primary Care Plus (CPC+) model and for new participants in the Next Generation Accountable Care Organization (ACO) model for the 2018 performance year. Clinicians in the Oncology Care Model (OCM) with two-sided risk in 2017 will qualify as participants in an advanced alternative […]
Business valuation is as much an art as a science. It not only requires technical knowledge of valuation methodologies, it requires the valuator to have significant judgement and the industry experience to evaluate the entity in the context of a broad understanding of the industry. One area where a valuator must exercise considerable judgement is […]
For your convenience: APMs = Alternative Payment Models MIPS = Merit-based Incentive Payment System QPs = Qualifying APM Participants CEHRT = Certified Electronic Health Record Technology The MACRA rule has introduced a load of new acronyms (see above), but here is another wrinkle. What exactly is an “Advanced” Alternative Payment Model? Luckily, several attorneys […]
For your convenience: MACRA = Medicare Access and CHIP Reauthorization Act QPP = Quality Payment Program APMs = Alternative Models MIPS = Merit-based Incentive Payment System CMS has issued the much-anticipated final rule to implement the controversial Medicare Access and CHIP Reauthorization Act of 2015. MACRA replaced the sustainable growth rate formula for […]
To date, just under one-third of accountable care organizations (ACOs) have been eligible to share in savings. This situation is changing somewhat as ACOs gain experience in managing populations of patients for high quality and low cost healthcare. As of 2016, nearly 50 percent of Medicare lives were covered in non-traditional arrangements, including Medicare Advantage […]