Leaders of hospitals and health systems face an array of difficult challenges as they move into 2023. In light of the challenges providers face, the Veralon team has identified high-impact initiatives that may help systems turn the corner for a brighter 2023. Briefly, the challenges include: Weakened balance sheets that limit capital available for new […]
Analyzing and prioritizing service lines like a portfolio can support focused growth, even during a financial crisis. Cost cutting is critical but insufficient to ensure viability and success when the financial crisis faced by health systems is prolonged, as it has been in 2022. Health systems must also grow revenue. Tight budgets and limited access […]
Challenge: Design a strategy to become the market leader for oncology services across a broad region that accounted for implications of emerging trends specific to: incidence of tumor sites, population, evolution of care, competitor vulnerabilities, and oncology reimbursement. Contact our Thought Leader: Mark Dubow, Director, mdubow@veralon.com
Shifting a $1 trillion dollar industry from confidential contracts to publicly published pricing is a massive transformation. In the middle of recovering from the COVID-19 crisis, hospitals are responding to this transformation. Background: The hospital price transparency rules require consumer-friendly tools to help individuals shop for hospital services based on price. They also require hospitals […]
By recategorizing procedures previously designated inpatient only, CMS is actively redirecting a significant number of cases to Hospital Outpatient Department (“HOPD”) and community-based ambulatory surgery center (“ASC”) settings. We have discussed the impact this will have on outpatient surgery, and strategies to prepare. This outpatient shift will also affect cardiac services, creating both risks and […]
Rapid evolution in diagnostics and treatment for cancer care, innovation through genomics and predictive analytics, the continuing shift toward value-based care are hastening the migration of oncology from hospital settings to community-based centers. This raises the question: Is now the right time to invest in a community oncology center? The experiences of multiple health systems […]
Often service lines are just a marketing tool, branding assorted practices as a specialty service line without connecting the services in a meaningful way. By establishing a management structure for service lines, hospitals and health systems can create an organized system of care for patients to progress smoothly from service to service. As health systems […]
One of the most impactful final rules released by CMS in recent months is the CY 2021 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS-1736-FC). This rule includes several important policy changes, most notably the elimination of the Inpatient Only List on a phased schedule through CY2024 (when […]
CMS is launching a Radiation Oncology Alternative Payment Model (“RO Model”) that will profoundly affect radiation oncology economics, with a target start date of January 1, 2022. The RO Model will apply (or at least test) a bundled payment methodology affecting about 30% of eligible radiation oncology episodes. Revenue reductions may be as high as […]
Prior to the coronavirus pandemic, healthcare CEOs ranked financial challenges (e.g., reducing the operating costs for staff and supplies, declining reimbursement) and increasing competition from other providers, among the top issues facing hospitals. But with coronavirus expenses straining hospital budgets, in 2020, a new element, service line optimization has become critical to hospitals’ ability to […]