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.
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.
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.
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.
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.
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.
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.
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.
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.
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.