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The Centers for Medicare & Medicaid Services (CMS) has announced updates to the Medicare Shared Savings Program (Shared Savings Program) and Medicare Direct Contracting models due to the Covid-19 public health emergency (PHE), both of which require immediate action. These updates include an imminent deadline, as early as next month, for Shared Savings ACOs to […]

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The Covid-19 public health crisis has had a substantial financial, economic, mental and physical health impact in the U.S. and around the world. Health systems and hospitals have had to increase hospital capacity, stop elective surgeries and adjust their workflows significantly to deal with the shifting needs of the community and patients serve. Outpatient and […]

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During the 20th century, two world wars and numerous regional military conflicts claimed more than 150 million lives and decimated entire countries. During the past 100 years, trillions of dollars have been expended assembling armies and building military preparedness to defend homelands and protect the citizenry. However, it has taken less than three months for […]

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Introduction The Covid-19 pandemic has created a barrier to health care at a magnitude the likes of which our industry has never seen. Many patients are terrified to receive care in traditional health care settings. There are abundant anecdotal accounts of patients suffering from heart attacks, strokes and other severe illnesses due to fear of […]

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Health systems, hospitals and medical groups have had to significantly adjust to the continued financial impact of Covid-19. Payor contracting, including expectations under existing agreements, has taken on a new dimension because of emergency regulations, waivers, use of numerous technologies and other short-term accommodations. It is more important than ever to identify and act on […]

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The Chinese saying, “Crisis equals opportunity,” may seem callous with relation to the Covid-19 pandemic; however, it is definitely apt. By most indications, the next several quarters, if not years, will be daunting for senior leaders, boards, and the health systems and hospitals they run, while at the same time creating new opportunities for those […]

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Independent Physician/Provider Associations (IPAs) are key mechanisms for physicians, health systems and federally qualified health centers (FQHCs) to align and engage in value-based payment arrangements that add value to payors and attributed members. Here we discuss benefits to IPAs for engaging FQHCs and community-based organizations (CBOs) into their network, and care model and funds flow […]

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Given the rising unemployment rates as a result of Covid-19, health systems and IPAs should expect an increase in their Medicaid population as people lose their employer coverage and shift to Medicaid or exchange products. Health systems and IPAs will need to look at their FQHC strategy to help manage their growing Medicaid population. This […]

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Introduction The federal government has announced multiple grant and loan funding opportunities to aid health care providers facing increased expenses and lost revenues due to the Covid-19 pandemic. It is anticipated that additional federal funding will become available as the pandemic continues. Many of these funds, however, are first-come, first-served. Health care providers need to […]

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Background: On May 12, the New York State Department of Health (NYSDOH) submitted an extension request to the Centers for Medicare and Medicaid Services (CMS) for the Section 1115(a) Waiver for funding authority of $2.75 billion to respond to the Covid-19 public health emergency. The request comes after surmounting pressure on the federal government […]

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