Assembling the essentials for successful population health management
A high-performing clinical network, and a focus on patients presenting high or emerging risk are two key elements that health systems must have in place to be able to succeed with population health management.
States look to Medicare-based reference pricing as the solution to price variation for employee hospital services
To reduce prices paid for hospital services delivered to their employees, Montana and North Carolina are pursuing reference pricing based on Medicare rates.
How a Hospital or Health System Can Assess the Risk of Moving to Value-Based Payment
To gain a clearer understanding of the financial impact of transitioning to a value-based model, healthcare executives can learn from the experiences of another health system that has undertaken a similar migration.
How to refine medical record sharing to mitigate risk and improve productivity
Careful review of medical record sharing costs and responsibilities stated in managed care contracts can reduce providers' expenses and productivity burden during payer reviews and audits.
Drivers of healthcare cost growth, and commercial health plans’ responses
Efforts to control the growth of healthcare costs nationwide have focused on reducing variation both in utilization and price.
FTC commissioner: Agency to continue ‘aggressive enforcement’ of hospital deals
A leader of federal antitrust enforcement touted a continuation of “aggressive” enforcement against hospital deals, even as the share of independent hospitals shrank to a historic low.
Specialty practices use predictive analytics to enhance value-based care
Specialty physician practices embarking on value-based care initiatives should start by expanding their ability to collect and synchronize data.
Part D savings plan dialed back
Part D plans will have fewer new tools to control drug spending than Medicare initially proposed.
Safety net hospitals issue warning about looming DSH cuts
Faced with $4 billion in cuts to Medicaid uncompensated-care payments that start in October, some hospitals warn they may have to close.
Short-term plans have little adverse effect on insurance market: study
Although a federal boost to short-term insurance plans raised alarm among hospital advocates, early evidence suggests there has been little adverse impact on the individual insurance market.