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Background In 2013, the Texas Legislature created The University of Texas Rio Grande Valley (UTRGV) to increase educational opportunities in the surrounding Rio Grande Valley area, located at the state’s southernmost point along the Mexican border.1 The Rio Grande Valley has an estimated population of about 1.5 million residents.2 In conjunction with the school’s founding, […]

The Centers for Medicare and Medicaid Services’ (CMS) Direct Contracting (DC) Model Options, a new set of voluntary payment models announced this week by the U.S. Department of Health and Human Services (HHS) for Medicare fee-for-service patients and their health care providers, represent a major step forward for population health management and value-based care. Based […]

As health systems seek or are forced into risk-based contracts, aligning stakeholders and developing a comprehensive strategy to create a culture ready for change is key. Regardless of your system’s current level of maturity with risk contracts or its ability to manage care for a population, moving from fee-for-service payments to global risk or capitated […]

It is no trade secret that physicians drive quality and medical spend in the health care industry. Across the nation, health systems, independent physician associations (IPAs), and accountable care organizations (ACOs) are challenged to effectively partner with their physicians to achieve high-quality outcomes and reduce the total cost of care. Those organizations most successful in […]

As 2019 begins, health care plans and provider systems are rightfully perplexed by the clamor of continued Trump Administration efforts to erode the Affordable Care Act (ACA), as well as the broad, and somewhat conflicting, policy assertions of other transformation initiatives. Examples of conflicting policy assertions are found in the Centers for Medicare and Medicaid […]

Introduction Hospital and health systems that strive toward value-based payment as their primary payor engagement strategy become more accountable for costs and health outcomes after a patient leaves an acute care facility. Medicare has already made this accountability a fact of life for all hospitals serving Medicare members through the value-based payment and re-admissions penalties […]

Introduction Hospital and health systems that strive toward value-based payment as their primary payor engagement strategy become more accountable for costs and health outcomes after a patient leaves an acute care facility. Medicare has already made this accountability a fact of life for all hospitals serving Medicare members through the value-based payment and re-admissions penalties […]

Libertarians, and others frustrated with the costs and strictures of regulation, may express the view that regulation of the insurance industry is often burdensome and unnecessary. Without addressing the global topic, there is a solid argument that good regulation serves the public interest through supporting ongoing confidence in the insurance market in which the public […]

Concerns about unsustainable health care costs, opportunities to improve quality and outcomes, the need for culturally competent care, and other market forces are leading to more value-based care payment and delivery models. These models require the leveraging of new technologies and changes in the delivery of care. This puts additional pressures on a workforce in […]