OIG’s 2016 Work Plan Expands Focus on Delivery System Reform

Board members overseeing risk management and compliance can now view the chief healthcare regulatory agency’s 2016 Work Plan, a blueprint of projected investigations over the coming year.   The Department of Health and Human Services Office of Inspector General (OIG) issued its work plan in early November and noted that it “will expand its focus […]

Hospital-Physician Integration Increases Outpatient Prices

Hospital-physician practice integration has been shown to increase outpatient prices in some metropolitan statistical areas (MSAs) according to a national analysis of the effect of such deals over several years. The results were published in JAMA Internal Medicine in mid October.   The study comprised practices in 240 MSAs with seven million enrollees in preferred […]

Hospitals Starting Health Plans Face Credit Risks

An emerging trend among not-for-profit hospitals positions them well for population health management but also carries significant credit risks, say Moody’s Investors Service analysts in a recent report. The trend is to enter the commercial health insurance business to both improve care management and gain market share, the analysts wrote.   The effect on credit […]

Studies Report Decline in Inpatient Mortality

Mortality rates decreased among patients admitted for acute myocardial infarction (AMI), congestive heart failure (CHF), stroke and pneumonia from 2002 to 2012, according to the Agency for Healthcare Research and Quality (AHRQ). The decline occurred for both men and women, and for Medicare-aged and younger patients.   The Journal of the American Medical Association (JAMA) […]

Study Finds Large Reductions in Medicare Hospitalization and Spending

Authors of a new study speculate that combined improvements in health, patient utilization patterns for health care, and healthcare delivery have dramatically reduced hospital utilization and per-beneficiary spending, while mortality declined among all Medicare fee-for-service enrollees, over the last 15 years. The research was published online in the Journal of the American Medical Association and […]

New Healthcare System Requires CFO and CMO Collaboration

Effective collaboration between the clinical and financial leaders of healthcare organizations is increasingly necessary, according to a recently published joint report from the American Association for Physician Leadership and the Healthcare Financial Management Association.   Providers, insurers, regulators and the public recognize the need for greater value in health care—that is, improved quality and lower […]

Clinical Integration Trumps Physician Employment

As payment moves from volume to value, many hospitals/health systems have begun to employ physicians as a business strategy, seeking to align with physicians around common goals and objectives. The Healthcare Financial Management Association (HFMA) reports, however, “many health systems have found that alignment does not automatically follow employment and that the employment model can […]