Large health systems and other healthcare groups including the American Medical Association and the American Hospital Association (AHA) have approached the current Administration with suggestions about how to rework the Medicare Shared Savings Program’s accountable care organizations (ACOs). These groups contend that the timeframe for taking on risk is too short and the bonuses […]
Last week we presented the Healthcare Financial Management Association’s (HFMA) Value Project strategies for value transformation. To make the strategies actionable, we now present the tactics identified by the Value Project. These tactics provide a roadmap that enables boards and executives to plot their organizations’ course to value transformation. To recap, organizations cross four […]
Organizations cross four major “summits” to achieve the ACA’s Triple Aim of improving the patient experience, advancing population health and lowering the total cost of care, according to the Healthcare Care Financial Management Association (HFMA). Through its Value Project, HFMA worked with a diverse group of 35 hospitals and health systems to identify and detail […]
Note: iProtean will observe the holidays beginning December 24 and will resume on January 7, 2015. We wish everyone a very happy holiday season! Although there has been a drop in numbers of uninsured patients following the rollout of the Affordable Care Act, the remaining uninsured have driven up “uncompensated care” to an all […]
Pioneer accountable care organizations (ACOs) and Medicare Shared Savings Program (MSSP) ACOs have saved $372 million to date and provided participants $445 million in bonuses, the Centers for Medicare and Medicaid (CMS) reported this week. The results came from preliminary quality and financial results from the second year of 23 pioneer ACOs, and from […]
A recent roundtable of policymakers and researchers in Washington D.C. exposed differing viewpoints about the competitive aspects of hospital consolidations. Because the impact of consolidation on competition and prices in a market continues to excite discussion and controversy, the participants called for regulators to approach their antitrust scrutiny from a different perspective. Some roundtable […]
The Centers for Medicare & Medicaid Services (CMS) recently issued final revisions to the Medicare conditions of participation (CoPs) that pertain to medical staff organization and participation in hospital governance. The key revisions include the following: Removing the requirement that a medical staff member serve on the governing body Allowing for a unified and […]
Competition continues to be on the priority agenda for the Federal Trade Commission (FTC). It recently hosted a workshop to gain input from healthcare industry experts about the degree to which promoting healthcare competition is integral to improving quality, lowering costs and expanding access. The FTC’s focus on competition isn’t new—it devoted a lot […]
The Affordable Care Act’s health exchanges have been overwhelmed with last minute sign ups, and the results so far indicate more than seven million enrollees. How this “new” market of insured customers will affect hospitals is the subject of a recent report from Moody’s Investors Service. Highlights from the report appear below. There are […]
Stock prices for large publicly traded insurance companies have risen in recent weeks, signaling investors confidence that health reform will improve insurance companies’ bottom lines despite dire warnings from the industry itself. America’s Health Insurance Plans, the industry’s trade group, has been predicting a troubling if not catastrophic outlook for insurance companies. It cited […]