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A recent headline, “With 8k more physicians than Kaiser, Optum is ‘scaring the crap out of hospitals: ’1 is resonating within the hospital sector, as it reinforces what many hospital system executives are facing: either becoming a partner – or fearing becoming a “cost center.” The article’s premise – that two behemoths are battling it […]

Patient experience has a direct impact on the bottom line of hospitals and health systems. Satisfied patients, and often their families, can lead to improved market share as the health system builds a positive reputation in the community. Additionally, physicians are becoming increasingly responsible for patient experience as payor contracts begin to incorporate value-based arrangements […]

The transition from fee-for-service to value-based contracts is a challenge faced by the health care industry. The ability to succeed in value-based payment contracts is critical for public hospitals that are often the primary safety net for a given community. Without the right operational foundation and data-driven strategy, organizations can easily jump into a risk […]

By now, it is well documented that a small percentage of “super users” account for over half of the health care costs in the country. A concept first brought to mainstream attention by Atul Gawande’s oft-cited 2011 article Hotspotters, identifying these super users and establishing targeted interventions has the potential to both vastly improve these […]

Recent announcements from the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) indicate that the current administration sees cost savings opportunities when providers, including hospitals, take downside financial risk. HHS Secretary Alex Azar commented, “There is no turning back to an unsustainable system that pays for procedures […]

ACOs that started in the Medicare Shared Savings Program’s Track 1 in either 2012 or 2013 must determine whether to move to a risk-based model by their third contract periods, which begin in 20191. A number of the MSSP ACOs are making strides in improving quality, reducing hospitalization and waste in Medicare. The Centers for […]