The finances of acquired hospitals generally suffer for two years after mergers and acquisitions (M&A), according to a recent report from HFMA and the Deloitte Center for Health Solutions. M&A activity has increased significantly in the past decade, driven by the pursuit of economies of scale and the potential for reducing the cost of […]
Hospital systems and health insurers have very different financing structures. Hospital boards and executive management will want to consider the fundamental differences when considering whether to combine both organizations within the same larger health system. Briefly, the health system has these fundamental financial structure characteristics: Significant physical plant investment Fewer growth opportunities Higher margins, […]
Hospital inpatient drug costs have been rising and this will continue, but at a moderate pace due to public scrutiny of pharmaceutical companies’ drug pricing practices. Moody’s noted in a recent article that even at a slower rate of growth, “we expect rising drug costs will continue to challenge hospitals’ financial flexibility.” (“Not-for-profit and public […]
(The following is an excerpt from “Different Economics, Different Payment: Call Coverage Stipends for Employed vs. Independent Physicians,” Veralon INSIGHTS, September 2017. Dan Grauman, one of our expert presenters, is the Managing Director and CEO of Veralon Healthcare Management Advisors. For the full article, please see the link below.) “Physician employment agreements now commonly […]
Reporting and collecting data for 2017 for the Merit-based Incentive Payment System (MIPS) should be underway in provider organizations. But some may have decided to wait because of what they perceive as high administrative and labor costs. According to experts, these organizations “are well advised to take a closer look at the potential benefits and […]
Over the first three years of the Medicare Shared Savings Program (2013-2015), 428 Accountable Care Organizations (ACOs) served 9.7 million beneficiaries. Most of these participating ACOs reduced Medicare spending compared to their benchmarks, resulting in a net spending reduction of nearly $1 billion, according to an August report from the Office of the Inspector General […]
Medicare payments to hospitals under the inpatient prospective payment system (IPPS) will increase by about $2.4 billion in fiscal year (FY) 2018 under final rule CMS issued August 2. The increase is less than the $3.1 billion anticipated under the proposed rule released in April. The rule will take effect October 1. In its […]
Economists estimate that 80 percent of all the cost of health care relate to social determinants of health. These include everything from exercise and healthy diet and healthy weight, to avoiding substance abuse and/or other self-destructive behaviors, to ensuring that people have adequate nutrition and housing. Those are big social issues that hospitals and health […]
(The following includes excerpts from our upcoming course, Strategic Issues for Boards, as well as information that didn’t make the cut.) MACRA creates two different tracks for clinicians to participate in Medicare. One is called the Merit-Based Incentive Payment System, or MIPS. The second is the Advanced Alternative Payment Model (AAPM). Each of these […]
About half of hospital-based physicians said they were not knowledgeable about the Medicare physician pay overhaul (Medicare Access and CHIP Reauthorization Act of 2015—MACRA) that began earlier this year, according to a recent survey by KPMG and the American Medical Association. This represents a larger share compared with physicians in other settings. The survey […]