What to expect from Medicaid block grant waivers
HFMA's Chad Mulvany says the macro design choice that matters to most to providers in any state that adopts the block grant program will be whether the state chooses the true block grant financing option, or if it selects a per capita cap based on the prior year’s enrollment.
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.
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.
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.
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.
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.
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.
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.
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.
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.