Blog
Kaiser Permanente Mobilizes COPE Health Scholars to Fill Pandemic Staffing Shortages
February 23, 2021An innovative workforce development and training partnership with COPE Health Solutions’ COPE Health Scholars enabled Kaiser Permanente to quickly fill critical staffing gaps at several medical centers during the pandemic. Kaiser Permanente Irvine Medical Center, Kaiser Permanente Anaheim Medical Center and Kaiser Permanente Orange County hospitals tapped this unique solution to supplement depleted staff in […]
How to Optimize Your CIN and Prepare for Success with Downside Risk
January 26, 2021Given the impact of COVID-19, health systems are rethinking how to align with and assist physicians. It’s an integral part of the opportunity to reimagine their future with respect to their market, their medical staff and the community they serve. They should look no further than clinically integrated networks (CINs). CINs have already proven, in […]
Two Payer Priorities in 2021: Member Growth and Provider Networks
January 26, 2021In the recent Health Payer Specialist article “The Biggest Challenges Facing Payers in 2021,” COPE Health Solutions CEO Allen Miller called out two areas. Rising Demand: Enrollment on the ACA-mandated health insurance exchanges is expected to grow. Indeed, a proposal to increase subsidies and expand ACA insurance eligibility is part of the Biden $1.9 […]
Forget Amazon. Health Plans Can Help Fix What’s Ailing the COVID-19 Vaccine Rollout
January 26, 2021Maybe you’ve seen this quip floating around Facebook: It’s funny and may even end up containing an element of truth. Amazon recently offered up its infrastructure, operations and tech to the Biden administration to improve the COVID-19 vaccine rollout. An even better (and more realistic) idea? Leverage health plans, their provider networks, member engagement and […]
3 C’s for Succeeding with Medicare Direct Contracting Geographic Model
January 26, 2021Is the new Medicare Direct Contracting Geographic (Geo) model from the Centers for Medicare and Medicaid Services (CMS) a fit for your organization? As the anticipated April 2 deadline for the Geo application approaches, it’s important to understand how Geo compares to other risk-contracting models and evaluate your readiness for pursuing that option. What […]
Using Claims-based Data for Covid-19 Vaccine Reporting
December 23, 2020With the approval of two highly anticipated Covid-19 vaccinations, America has entered into a long-awaited new phase in battling the Covid-19 pandemic: Vaccination. The Pfizer – BioNTech1 Covid-19 vaccine and the Moderna2 Covid-19 Vaccine were both approved for use last week. Thanks to decades-long advances in healthcare infrastructure and technology, we have never been better […]
Medicare Direct Contracting Geographic Model Fact Sheet
December 17, 2020Program Structure and Features The Medicare Direct Contracting (MDC) Geographic Model, or “Geo”, is the third of three available MDC models released by CMMI. The Geo Model is a population based payment (PBP) model that will offer Direct Contracting Entities (DCEs) the opportunity to assume risk for the total cost of care for Medicare fee-for-service […]
Aligning Your Medicare Direct Contracting Model with Your Value-based Payment Strategy
December 16, 2020Medicare Direct Contracting (MDC) is a set of mature, capitated payment models for Medicare Fee for Service (FFS), evolved from legacy accountable care models (e.g. Next Generation, Medicare Shared Savings Program), and released by the Centers for Medicare and Medicaid Services (CMS) in November 2019. MDC has recently gone live with its first cohort of […]
Providers Want Capitation, But What Are Health Plans Thinking?
December 15, 2020Health plans recognize that a successful future requires strategic ties to their provider partners to ensure patient access and high quality care. Payers and providers alike have saluted the Affordable Care Act (ACA) precept that such partnerships involving advanced payment methodologies are beneficial for patients, providing financial incentive to providers and resulting in lower costs […]
What You Need to Know About the CMS Geographic Direct Contracting Model
December 5, 2020The Centers for Medicare and Medicaid Innovation (CMMI) has just announced that non-binding letters of intent (LOI) from health organizations who are serving Medicare beneficiaries in one of 15 different Core Based Statistical Areas (CBSA) around the country and are ready to participate in “Geographic Direct Contracting” must be submitted to CMS by 11:59 p.m. […]