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 […]
The outlook for U.S. not-for-profit hospitals remains negative for 2013 according to Moody’s Investors Service. Its recent Industry Outlook (January 22, 2013) cites continued erosion of hospital revenue and a “tepid economy that dampens demand” as the primary factors in its assessment. Revenue growth will remain positive but will continue to decelerate because of Federal […]
In January, the Centers for Medicare & Medicaid Services (CMS) selected an additional 106 accountable care organizations (ACOs) to participate in the Medicare shared savings program. (Health Lawyers Weekly, January 11, 2013) CMS noted that about half of the new ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries. Approximately 20 percent are […]
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 […]
When Congress passed the American Taxpayers Relief Act to avoid the “fiscal cliff” on New Year’s Day, it included a remedy for the anticipated 26.5% cut in payments to physicians who treat Medicare patients—shifting the financial impact of that “doc fix” to hospitals and other healthcare programs. Hospitals will bear nearly half of the […]
The American Hospital Association urged Congress last week to avoid cuts to Medicare and Medicaid payments to hospitals as they negotiate debt reductions. Much is at stake here—the 2% fiscal cliff cuts (“sequestration”) to Medicare providers as well as additional cuts that may affect hospitals and physicians; for example, offsetting the “doc” fix by shifting […]
The recent study on value-based purchasing compared projected total performance scores (as defined by CMS as part of value-based purchasing) with Medicare cost report data for corresponding measurement periods. The results of the study suggest that higher routine costs per day result in the highest level of quality. When evaluating the cost of patient experience/satisfaction, […]
Guest Submission: Barry Bader, Bader & Associates Physician participation on hospital boards has been a widely recommended practice for several decades—a way to strengthen hospital-medical staff relationships and build the board’s competency in clinical matters. Surveys generally show that 15% to 25% of the typical hospital board is composed of physicians, often including the […]
As boards grapple with the structural components of the Affordable Care Act—value-based purchasing, accountable care organizations, bundled payments, etc.—they need to also keep their eyes on the private insurance components of the Act. These features garner the most attention in the mainstream media but even so, are not well understood by the general public. […]