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As the national health care landscape continues to shift towards value-based payment (VBP) models, the traditional approach by health systems and hospitals of measuring market share based on percent of admissions in a given market is putting them at a growing disadvantage. They must adopt the most telling measure for risk-bearing organizations, which is how […]

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Like hospitals everywhere, St. Joseph Hospital Orange and Mission Hospital faced the challenge of meeting the demand for COVID-19 immunizations while concurrently balancing the impacts of pandemic-related staffing shortages. The two Providence hospitals in Southern California turned to COPE Health Scholars, aspiring health professionals already on site as part of hands-on experiential education courses, to […]

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Technology and data are essential foundations for value-based care. But knowing how to maximize the use of both is not always clear or straightforward for clinicians who are focused on patients and their care. To help fill that gap, COPE Health Solutions and the other members of the Alliance for Technology-Driven Health have launched “The […]

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What a wake-up call. On the heels of the Centers for Medicare & Medicaid Services (CMS) suspending Medicare Direct Contracting for most new applicants and sunsetting the Next Generation ACO model, the new director of the Center for Medicare and Medicaid Innovation (CMMI) last week signaled a likely move toward requiring providers to take financial […]

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With the May 21 announcement that it was discontinuing the Next Generation ACO Model at the end of 2021, the Biden Administration continues to move decisively to put its stamp on The Centers for Medicare & Medicaid Services. While this decision has serious implications for NextGen ACOs participants, they are not alone.  The in-progress reassessment […]

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If you’re like me, you remember the first round of capitated payments in the late 1980s and early 1990s. There were some good reasons why that grand experiment in managed care eventually collapsed, but one of the biggest culprits was lack of useful and actionable data as well as detailed analytics. Providers and payers did […]

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Under the Biden administration, the Centers for Medicare & Medicaid Services has paused its 2021-22 contracting cycle for Medicare Direct Contracting and is assessing its other alternative payment programs. While many are busy trying to read the tea leaves as to which programs will survive and which will be cut, two patterns are clear: Programs […]

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If you were shut out of Medicare Direct Contracting (MDC) when the Centers for Medicare and Medicaid Services (CMS) recently announced it would not accept new 2022 applicants, all is not lost. The pause on new MDC applicants is part of a broader examination of CMS’ various Medicare models to encourage value-based care and value-based […]

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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 […]

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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. : […]

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