Finding Common Ground in Health Care with a Divided Government
Ken Perez comments on the need for both parties in Congress to set aside partisan differences and find common ground in passing bipartisan legislation to solve key problems affecting the nation’s healthcare system.
Hospitals Issue Warnings on ACA Repeal Ruling
Dec. 17—Hospital advocates raised a range of concerns about the expected impacts of striking down the Affordable Care Act (ACA) after a federal judge’s recent decision that the law was invalid.
Not Just Smarter Payment, Better Health Care
Jeb Dunkelberger describes how Highmark Health uses its experience as an integrated care delivery and finance system to advance strategies that improve the value of health care.
Why the Election Results Matter For 340B Hospitals
Ted Slafsky provides an insider’s perspective on where the 340B drug discount program is headed after the consequential midterm elections.
The 2019 ACA Enrollment Period Begins
Rising premiums and reduced choice among insurance options are two challenges facing health insurance purchasers under the Affordable Care Act in 2019; nonetheless, public support for the act continues to be strong enough to block efforts to repeal the act.
Transitioning to a New Medicare Benchmarking Paradigm
As commercial health plans adopt a case-rate approach to payment based on Medicare’s MS-DRGs, modifications are needed to account for how health plans’ populations differ from the Medicare population.
Bundled Episode “No-Go” Zone
Providers that are considering participating in bundled payment arrangements should first perform a preliminary review of factors that can have a bearing on their readiness for such arrangements.
The Trump Administration’s Proposed Reorganization of the Federal Government: Implications for Health Care
President Trump is proposing significant reforms to government structure that may improve administrative efficiency but may at the same time gut what is left of the nation’s safety net.
Target Setting: A Case Example with Risk Adjustment
By considering risk as they set financial targets for physician groups under value-based payment contracts, provider organizations can more accurately assess the likelihood that physician groups might have favorable performance under the contracts.
Lessons Learned from New York State’s Transition to Value
New York is a leader among U.S. states in promoting the healthcare industry’s transition to value-based payment, and healthcare providers nationwide can benefit from understanding the details of the state’s approach.