This white paper outlines the current market pressures placed on healthcare providers, as well as ways they can focus their response to industry shifts. In particular, it outlines a transformation strategy that involves rapidly launching new business initiatives while cutting programs that have...
Modern Healthcare recently spoke with Dan Wolterman, president and CEO of Houston-based Memorial Hermann Healthcare System, about accountable care, tensions with insurers over starting a health insurance arm, and Memorial Hermann's shift to outpatient care.
New payment models adopted by Medicare and many health plans have clearly led to better care for patients. They also might be helping to slow the overall growth of healthcare spending.
The fix isn't in yet, but it's close. The Senate adjourned for its spring break Friday without taking action on legislation permanently repealing and replacing Medicare's sustainable growth-rate physician-payment formula.
Variables such as market competition, previous experience with Medicaid managed care and the level of physician integration all play a role in the pace at which health systems adopt value-based payment models.
Health systems that hope to profit under accountable care or bundled payments will likely fail to do so without plans to sharply cut hospitals' operating costs.
Medicare's new “Next Generation” accountable care organization program has raised hopes among many healthcare providers that the Obama administration is listening to them as it pushes ahead toward value-based payment models.
Alternative payment models come in different forms, such as bundled payments or ACOs. Physician practices and other organizations preparing for new reimbursement models should consider their patient population and their ability to take on risk, and experiment with their current payer mix.
New York's Montefiore Medical Center, the most financially successful of Medicare's most sophisticated accountable care organizations, may bypass what HHS officials are calling the next generation of the evolving payment model.
Blue Cross and Blue Shield of Massachusetts wants to expand its use of global budgets outside of managed care. But the plan's success will depend on how many doctors are willing to accept the risk.
Catholic not-for-profit SSM Health Care, St. Louis, will join the Integrated Health Network of Wisconsin, allowing the accountable care organization to expand into south-central Wisconsin.
Regarding the article “If fee-for-service is a problem, what's the solution?”, replacing the fee-for-service payment model with something better is necessary, but not sufficient to achieve healthcare reform goals of the triple aim—improved health for populations served, better...