Blog

Network leakage is a priority for 96% of health system and hospital executives, and more than 79% have been working to decrease leakage for more than three years.1 For those searching for a solution to address this pressing issue, Montefiore Medical Center Bronx has cracked the code. The academic medical center in the Bronx is […]

In the recent Crain’s New York Business article “Pandemic will have little impact on future of hospital pay,” COPE Health Solutions CEO Allen Miller made two key points about health care executive pay.  : 1. Hospital CEOs and their senior executive teams face considerable challenges only made more difficult by the pandemic. : […]

It’s been more than 18 months since U.S. Health Resources & Services Administration (HRSA) added any new access point (NAP) grants to establish care clinics in underserved areas. Given the success of those grants and the fast-approaching August 31, 2021 end to the current two-year funding period, providers should begin preparing now to apply for […]

The COVID-19 pandemic has escalated already high levels of burnout, creating a tipping point for growing numbers of doctors, nurses, other providers and health care employees. 1 in every 4 (26%) U.S. health care workers has considered leaving their job since the start of the pandemic.1 14% are thinking of leaving the health care profession […]

Provider and payer success in Medicare Direct Contracting (MDC), a voluntary program for fee for service beneficiaries, hinges on earning member loyalty through a strong care infrastructure and provider referral network. The pace and path forward differs a bit depending on whether you are one of the 53 MDC Direct Contracting Entities (DCEs) that launched […]

The Centers for Medicare & Medicaid Services’ latest model for risk-based payments and care offers the potential to significantly advance clinical transformation and value for payers, providers and their patients. As we noted in the recent webinar “Medicare Direct Contracting: What Payers and Providers Need to Succeed,” Medicare Direct Contracting Entities (DCE) have a unique […]

Ready or not, the Centers for Medicare and Medicaid Services is moving more strongly to downside risk. That’s especially true with Medicare fee-for-service as CMS continues to expand the Medicare Direct Contracting (MDC) program even as it delays the geographic option. Attendees will learn: The differences between global and professional MDC models Possible next steps […]

Background Dr. Mary Carol Jennings, MD, MPH, is the Chief Medical Officer of Sendero Health Plans, a local non-profit health plan based in Austin, Texas. Sendero offers individual insurance coverage on the Affordable Care Act’s (ACA) Marketplace and is unique among other payers in the focus it places on ensuring access to affordable, quality healthcare […]

This new feature in ARC allows the user to filter for specific diseases across the population. Meaning, the user can now see data on the page specific to a population of members with that chronic disease. Below is an example of the drop down and the available chronic disease options.   The filter is available […]

Necessity really is the mother of invention. During the pandemic, providers quickly scaled alternative care options, including telemedicine and hospital at home. Now, payment structures need to catch up. The reliance on fee-for-service (FFS) and traditional patient care models during the pandemic hurt both providers and members. Non-COVID-19 patient care plummeted—even for people with chronic […]