6 Tactics of Successful ACOs
To gain the assurance of success under value-based care, all accountable care organizations (ACOs) should adopt the best practices of the most high-performing ACOs.
Home Is Where the Hospital Is
The hospital-at-home model provides a potential means of reducing total costs of care and improving outcomes, but it would present traditional acute care hospitals with a strategic challenge.
Medicare Advantage for More: A Pragmatic Alternative to Medicare for All
An expansion of Medicare Advantage presents an opportunity for the U.S. to test the waters of a single-payer system.
Definition of “Employer” under Section 3(5) of ERISA – Association Health Plans Final Rule Executive Summary
This document summarizes the Employee Benefits Security Administration's Association Health Plans final rule, published in the June 21, 2018, Federal Register.
Who’s Afraid of a Little Risk?
The Medicare ACO modeled advanced by CMS has encountered some challenges, but it still holds promise if CMS addresses the flawed idea of retrospective attribution of patients to an ACO.
Health Plans, Providers Collaborate on Payment Transformation in Hawaii
More than 500 primary care providers have moved to per-member, per-month payments for patients covered by Hawaii’s largest health plan. The initiative may provide a roadmap for smaller physician practices to participate and flourish in the transition to value.
Bundled Payments for Care Improvement Advanced: 5 Critical Issues
When considering whether to participate in the Bundled Payments for Care Improvement Advanced program, hospitals and health systems should examine five key areas that could affect their performance under the program.
Federal Health Policy Changes Expected After Mid-Terms
May 4—The healthcare industry should prepare for major federal healthcare policy changes after the federal congressional election five months from now, no matter which party is in the majority, say policy analysts.
HFMA Overview: Affordable Care Act HHS Notice of Benefit and Payment Parameters for 2019 Summary of Final Rule
This presentation summarizes the Notice of Benefit and Payment Parameters for 2019 final rule, published by CMS, in the April 17, 2018, Federal Register.
Value: The Way Forward
Value-based payment won’t bend the cost curve unless healthcare organizations commit to fundamental change. Not everyone will come out whole.