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Delegated IPAs and medical groups in California provide valuable health care services to millions of Medi-Cal Managed Care, Medicare Advantage and Commercial Health Maintenance Organization (HMO) members. These “pioneer” providers practiced population health management before it gained industry currency and have utilized outcomes-based payment to incentivize provider innovation for decades. Risk-bearing medical groups and IPAs […]

Background: Benefits of a Post-Discharge Phone Program Hospitals have improved patient outcomes and patient satisfaction scores via implementation of a successful post-discharge phone call program to achieve: Improved patient outcomes: Patients receiving a post-discharge call were 23.1% less likely to be readmitted compared to patients who did not receive a call1. Early detection of adverse […]

Health care is in a tumultuous time and what’s for certain is that nothing is for certain. The passing of the recent Tax Cuts and Jobs Act of 2017 (TCJA) has broad but still not completely understood implications for the business community and economy, including non-profit health hospitals and health care systems, generally adding more […]

  Health care providers in Texas continue to work diligently to improve care delivery systems to all patients through Medicaid 1115 waiver transformation initiatives, specifically focusing on the Medicaid and low-income uninsured populations. The work of the Anchors and Delivery System Reform Incentive Payment (DSRIP) program providers in 2017 and previous years is evident in […]

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 with effectively partnering with their physicians to achieve high quality outcomes and reducing the total cost of care. Those organizations most successful […]

California public hospitals have a unique opportunity to leverage the PRIME program to help build the competencies needed to thrive in a risk-based environment. Public health systems and hospitals that make strategic investments in data analytics, network optimization, care management and quality improvement will be set up for success and long-term sustainability. Overview: The […]