Hospitals in more than five dozen metropolitan areas will soon have no choice but to take bundled payments from Medicare for hip and knee replacements. And the skilled-nursing facilities that do business with them face a stark reality of their own.
A closer look at two disruptive innovators in the new market for accountable care delivery.
Medicare's investment in accountable care organizations has inspired hospitals and doctors to create their own versions of ACOs with private insurers. But as with Medicare, not all private ACOs are achieving lower costs and higher quality.
By combining their diverse but complementary areas of expertise, providers and payers can increase market share and revenue as the industry shifts to value-based payment models.
Health information technology cognoscenti predict most large hospitals and health systems, physician groups and health plans can handle the numerous, complex and very specific new codes. Any cramps will appear later as providers' cash flows get hit by delayed reimbursements.
The possibility of a government shutdown Thursday could have a ripple effect on healthcare providers but mostly if the shutdown is prolonged. Congress is in an eleventh-hour race to pass a spending bill or risk a second government shutdown.
Understanding the Hispanic population represents a huge opportunity to improve community engagement, population health management and financial success—an opportunity that is largely being untapped. Read a roundtable discussion, download new research and more.
Identifying and resolving the most common disconnects between providers and payers can improve compliance, reduce administrative burdens and, most importantly, increase revenue and cash flow for providers.
Voce Capital Management, a San Francisco-based hedge fund, has asked air ambulance company Air Methods Corp. to consider selling itself to a private equity firm and avoiding the transparency of being a public company.
Until recently, insurers and providers did not have good ways of measuring the cost-effectiveness of post-acute care providers, and patients lacked clarity on what to expect after they were discharged. NaviHealth is trying to change that.
Four years into Medicare's drive to cut the number of patients who land back in the hospital within a few weeks of leaving, only a quarter of more than 3,400 hospitals avoided penalties, contributing to skepticism about the program and the array of metrics used to evaluate healthcare quality.
Some hospital system executives are citing booming insurer stock prices as a clear market signal that consolidation will give payers the upper hand in future price negotiations with hospitals and other providers. But insurers are not the only ones seeing strong results.