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Medicare Advantage and Medicare Direct Contracting Considerations for Health Systems and Medical Groups

September 28, 2021

It’s the time of year when Joe Namath and other personalities are taking to the airwaves to tell seniors about the benefits of Medicare Advantage (MA) plans. For seniors, choosing between traditional Medicare and MA plans during the annual enrollment period can have a significant financial impact. The same holds true for health care providers […]

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5 Key Takeaways on Why You Need a Project Management Office to Realize Your Value-Based Payment Strategy

September 28, 2021

The shift to value-based payments and value-based care is the most complex and far-reaching transformation being undertaken by U.S. health care in our lifetimes. One proven way to increase the chance of success in any project, let alone one the size and scope of the wholesale move to population health management and risk contracting, is […]

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Take These Two Steps Now to Address Workforce Burnout

September 28, 2021

In the recent Modern Healthcare article “Addressing healthcare worker burnout as another COVID-19 fall nears,” COPE Health Solutions Principal and Workforce Development Expert Elizabeth DuBois offers immediate actions providers can take to address some of the healthcare workforce’s acute pain while putting in place procedures and programs that take a strategic, longer-term approach to managing burnout. Two […]

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Webinar: Why You Need a Project Management Office to Realize Your Value-Based Payment Strategy

September 21, 2021

Only 62% of projects complete within budget and 56% finish on time, according to the Project Management Institute’s 2021 Pulse of the Profession. Worse, 25% of all projects fail completely. Value-based health care projects are highly complex, particularly due to the significant cultural shift required. Whether you are a health system, health plan, IPA or […]

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What You Need to Know About the New York Medicaid Waiver Proposal and Concept Paper

August 27, 2021

The New York State Medicaid Redesign team this week released a concept paper for a new 1115 Waiver, including a request for $17 billion over 5 years from the Centers for Medicare & Medicaid Services to build an enhanced health care delivery system as part of New York’s overall efforts to “reimagine, rebuild, and renew” […]

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Want to Close the Gap to Value? Focus on Culture

August 26, 2021

Everyone in health care fervently supports the goals of value-based care—better quality and better outcomes at lower costs. But transitioning from the traditional fee-for-service system to population health management and payments based on capitation or global risk with reconciliation raises legitimate concerns and obstacles for physicians, hospitals, health plans and consumers. True, many payers and […]

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To Increase the ROI on Strategic Initiatives, Consider Implementing a Project Management Office

August 26, 2021

If a financial advisor promised 25% of your investments would never produce returns, you probably would not trust that advisor with your financial future. Many businesses, though, do exactly that with their project investments. U.S. organizations have a 75% success rate for projects that achieve their planned goals or benefits, according to the Project Management […]

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Tackling Health Plan Challenges from Resurging COVID-19

August 10, 2021

As both payers and providers grapple with a new round of COVID-19 stress to the health system due to variants such as Delta and Lambda, health plans face a growing array of challenges requiring rapid and effective response. Contact tracing and immunizations have taken on a new level of priority as the Delta variant burns […]

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Relieving Provider Pressures During COVID-19 Second Wave

August 10, 2021

Providers barely had time to take a breath before confronting a new round of COVID-19, driven primarily by the Delta variant. Above and beyond caring for COVID patients, this deadly scourge continues to tax our health systems and their health care workers: Contact tracing and immunization campaigns remain imperative. The entire health care workforce, particularly […]

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Why Health Systems and Hospitals Need a New Definition of Market Share

July 28, 2021

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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