Contracting

Transitioning health systems to accepting more risk: Key steps to ensuring financial sustainability

The COVID-19 pandemic has renewed many health systems’ interest in pursuing population health initiatives. Yet success with such initiatives will remain elusive if they do not address two common barriers to success: lack of aligned incentives and insufficient infrastructure.

Orry Jacobs, MBA June 24, 2021

Continued growth in employer-paid healthcare premiums may spur employers to find alternative solutions

HFMA's Chad Mulvany says large employers have signaled a possible end to their patience for traditional players to provide a traditional solution, and he reviews what solutions they could pursue instead.

Chad Mulvany, FHFMA October 22, 2020

Healthcare organizations should expect a surge in managed care audits and reviews in the COVID-19 aftermath

Healthcare providers should prepare for emerging trends in payer audits, reviews and associated information requests, after the brief lull in such activities that occurred with the onset of the COVID-19 pandemic.

Greg Ford September 28, 2020

How to lay the foundations for success under CMS’s new MDC program

The CMS Medicare Direct Contracting (MDC) program offers hospitals and health systems a unique opportunity take the next step in value-based payment and population health management. Success requires the right targeted investments in expertise and infrastructure.

Allen Miller, MPH September 28, 2020

3 contracting strategies to accelerate a COVID-19 financial recovery for providers

Having suffered significant losses due to the COVID-19 pandemic, healthcare providers require effective strategies to achieve a more equitable balance with payers, which have actually enjoyed a financial windfall as a result the pandemic.

Kathy Najarian, MHA September 28, 2020

Rand releases updated study of hospital payment variation in commercial market

HFMA's Chad Mulvany says it’s imperative that everyone in the U.S. supports safety-net hospitals, or there will be an increase in the disparities in access to basic healthcare services between the haves and have-nots.

Chad Mulvany, FHFMA September 25, 2020

Business Group on Health’s Annual Survey: Large employers ready to take the reins on healthcare cost

Responses to the Business Group on Health's annual survey of its large employer members suggest employers are tired of waiting for providers and plans to figure out how to reduce healthcare cost.

Chad Mulvany, FHFMA September 11, 2020

Is another health plan featuring virtual PCPs as primary access point a sign of things to come?

HFMA's Chad Mulvany questions if the recent expansion of telehealth could stimulate a trend of plans offering virtual PCPs as the primary care access point.

Chad Mulvany, FHFMA May 27, 2020

How healthcare providers can avoid being at a disadvantage when negotiating risk contracts

Stratifying patients by risk helps finance leaders understand the cost implication differentials of shifts in utilization, giving their organizations a more solid footing in risk-based contract negotiations.

Daniel J. Marino March 16, 2020

How to achieve best-in-class capability for value-based risk contracting

Health systems embarking on value-based contracting should give attention to three areas: understanding market profit pools, acknowledging inherent challenges in the health plan market, and developing the key elements that are essential for success.

Richard Weil, PhD March 12, 2020
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