Payment Models

Is Walmart taking a page out of Clayton Christensen’s playbook?

Walmart developing a low-cost service focused on a segment of the market that traditional players tend to avoid – the uninsured and underinsured – may signal ambitions to move further into healthcare delivery.

Chad Mulvany, FHFMA February 7, 2020

Key takeaways from North Carolina’s move to value-based healthcare

Keith Moore, CEO of McManis Consulting, shares his perspectives on North Carolina’s move to value-based payment and what it means for hospitals and health systems nationwide.

Eric C. Reese, PhD February 4, 2020

Elizabeth Warren’s Medicare-for-All plan: The devil in the details

Any objective analysis of Elizabeth Warren’s proposal for Medicare for All should consider its enormous societal and federal costs, and its likely impacts on the health insurance industry and hospitals.

Ken Perez January 31, 2020

Analysis: Aspire Health Founder Brad Smith chosen as new CMMI director

The change in CMMI leadership could mean long-anticipated models are released, and may signal more emphasis on palliative care in future models based on Brad Smith’s background.

Chad Mulvany, FHFMA January 14, 2020

Cautionary tales: Why some payer-provider initiatives have stumbled

Health system leaders that are considering launching a provider-sponsored health plan can take a lesson from the experiences of organizations that faced challenges in pursuing such a strategy.

Richard Weil, PhD January 10, 2020

7 keys to engaging physicians for success under BPCI-A

Physician engagement is a critical success factor for health systems that are pursuing bundled payment initiatives.

Douglas Ardoin Jr., MD, MBA December 16, 2019

Analysis: Timeline for CMS’s mandatory radiation oncology model appears to slip

It’s not surprising CMMI has slowed its pace on finalizing the proposed mandatory radiation oncology payment model given the complexity of the model and stakeholder opposition.

Chad Mulvany, FHFMA December 11, 2019

4 goals for bundled payment: How a hospital succeeded under BPCI-A

Abington Hospital has enjoyed success under the Bundled Payments for Care Improvement Advanced model by focusing on four key goals, including identifying episodes with sufficient opportunities to reduce costs below CMS’s target prices.

Erin Hahn, MPH December 9, 2019

How CMS sets the target price for bundles under BPCI-A

Read a description of CMS's method for setting episode target prices under its Bundled Payments for Care Improvement Advanced model.

Erin Hahn, MPH December 2, 2019

It’s time to acknowledge the success of CMS’s MSSP

Eye on Washington: The Medicare Shared Savings Program has achieved some noteworthy successes, and the program's continued ability to be successful will depend on physician leadership and involvement.

Ken Perez December 2, 2019
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