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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 […]

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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 […]

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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 […]

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Publications | The Wharton Healthcare Quarterly PDF Logo Available also at https://www.whartonhealthcare.org/fee_for_service_to_value_s_part_3_part_b

Publications | HFMA hfm PDF Logo Available also at http://www.hfma.org/Content.aspx?id=60617&utm_source=Real%20Magnet&utm_medium=email&utm_campaign=126084056

The HFMA Annual Conference is the industry’s premier event for hands-on learning where executives from across the nation gather to solve complex issues, interact with peers and industry leaders, and get the tools they need to influence change and address challenges. This year's programming features new learning tracks and session formats that will amplify the power of networking and collaboration to facilitate deeper learning and greater innovation.
Presenter: Carla D'Angelo and Anush Gevorgyan

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2018 has been a year of uncertainty in federal and state health policy, particularly with respect to population health. Despite increasing complexity and ambiguity, most markets continue to move toward various forms of value-based payment (VBP). However, most health systems and physicians continue to operate in pluralistic payment environments, defined by having a portion of […]

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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 […]

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