A timeline guide to developing an ACO/CIN
Healthcare organizations seeking to establish a an accountable care organization (ACO) or clinically integrated network (CIN) should allow for an eight-year, five-phase process
Deceased Medicare beneficiary admissions: Accounting for the causes and impacts
Just over 3 percent of Medicare admissions end with the death of the patient. This finding is based on data from fiscal years 2015 through 2017 reported in the Medicare Provider Analysis and Review (MedPAR) file. As would be expected, the time and resources required to treat a beneficiary who is near death and ultimately…
Provider nimbleness required for diverse value-based healthcare models
Many providers are in the throes of implementing strategies for value-based health care. But now they must adapt to an environment characterized by diverse value-based care models, new players, and more data to discern provider value. To weather the next decade, the key attribute providers will need is nimbleness—a challenge in an industry not known…
Analysis: Comparing commercial hospital rates to Medicare is inappropriate
RAND study says hospitals treating patients with private health insurance were paid 2.4-times the Medicare rates, but Chad Mulvany says Medicare is the wrong measuring stick.
Medicare buy-in option beginning at 55 the most likely expansion route, says former CMS chief
If everything goes right for Democrats in the 2020 election, the most likely Medicare expansions are not the ones getting the headlines now, says a former Medicare administrator.
Analysis: Making smarter decisions about where to recover after hospitalization | HTML
HFMA’s Chad Mulvany looks at why the transition from acute to post-acute is one of the greatest opportunities to improve clinical outcomes, the patient/caregiver experience of care and reduce the total cost of care for older adults.
3 ways to remove the mystery from value-based payments
Daniel M. Grauman and Amanda Brown explain how analytic tools can assist a healthcare organization in identifying areas for improvement in value-based payments.
Policy changes needed to prevent hospital-based Medicare ACOs from being disadvantaged by high-cost patients switching from physician-led ACOs
CMS needs to implement changes to Medicare’s ACO models that hold hospital-led ACOs harmless when high-cost beneficiaries switch from physician-led ACOs.
‘Medicare for All’: Do the numbers
Healthcare leaders can foster a productive debate about “Medicare for All” by driving analyses based on data such as cost projections, writes HFMA President and CEO Joseph J. Fifer.
Analysis: The pros and cons of large statewide ACOs
Experts say because of their sheer size, “super-ACOs” can bring stability to benchmarks but be difficult to manage.