Transitioning from volume-based to value-based payment for care won’t happen on a specific date. Hospitals have long been paid on a volume-based payment model, and will continue to operate in that model while the new value-based payment model comes into play. Lisa Goldstein noted in a recent iProtean course that “the biggest challenge facing health […]
The Centers for Medicare & Medicaid Services (CMS) continues to take steps to reduce unnecessary and burdensome regulations on hospitals, according to a recent CMS press release. “Reforms to Medicare regulations identified as unnecessary, obsolete, or excessively burdensome on hospitals and health care providers would save nearly $676 million annually, and $3.4 billion over five […]
Dignity Health, Blue Shield of California and Hill Physicians Medical Group began working on a proto-type ACO in 2007 in response to pressure from the California Public Employees Retirement System (CalPERS), a large healthcare purchaser, and the resulting ACO seems to be doing very well. The ACO launched in January 2010, serving 41,000 CalPERS […]
A large health system has jump-started its efforts to link its financing and delivery system by adopting a population health management strategy for its own employees. Population health management is one of the triple aims of healthcare reform, along with high quality and low cost. All payers will continue to pressure top line […]
As the federal and state governments continue to implement the provisions of the Affordable Care Act, experts express concerns about the lack of physicians to care for the expanded pool of patients. “The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will […]
“There is no deadline for a state to tell our Department [CMS] its plans on Medicaid eligibility expansion,” said Marilyn Tavenner, acting administrator for CMS in a letter to the Republican Governors Association last week. Tavenner’s letter to the Republican Governors Association was in response to questions stemming from the U.S. Supreme Court’s recent […]
U.S. Department of Health and Human Services Secretary Kathleen Sebelius last week announced the approval of 89 new Accountable Care Organizations (ACOs) for participation in the Medicare Shared Savings Program (MSSP). The 89 ACOs will serve Medicare beneficiaries in forty states and Washington, DC. This brings the total number of ACOs to 154, including the […]
Improving quality and reducing cost, while always a staple of board and executive discussions and retreats, has catapulted to the top of the list of priorities because of components of the Accountable Care Act (ACA) and the Medicare Shared Savings Program: accountable care organizations, medical homes, bundled payments. Designing the structures and operational details […]
In mid-2011 Deloitte Center for Health Solutions surveyed a nationally representative random sample of U.S. primary care and specialist physicians to record their attitudes toward health reform and how it may affect the future practice of medicine. Among the findings were that physicians are split as to whether health reform is a good start or […]
The medical staff, though it has evolved over the last several years, faces additional pressures to accommodate the changing healthcare delivery environment. The American Health Lawyers Association recently sponsored an in-depth discussion of the hospital medical staff and how and why it is evolving; contemporary challenges to the traditional role including declining physician participation, […]