CMS Provides Relief for Quality Reporting Amid COVID-19 Crisis
On March 22, 2020, the Centers for Medicare and Medicaid Services (CMS) offered some relief for the clinicians, providers, and facilities participating in Medicare quality reporting programs – including the 1.2 million clinicians in the Quality Payment Program and those fighting coronavirus (COVID-19). This unprecedented action by CMS has been applauded by the American Medical […]
MSO Build or Buy: Strategic Considerations
Traditional management service organization (MSO) models have shifted away from purely administrative and management services in support of physician practices to more population health services organization (PHSO) models for independent provider associations (IPAs), accountable care organizations (ACOs), health systems or other provider entities taking premium risk from payors. MSOs are now focused on helping organizations […]
Health care experts forecast how hospitals must prepare for the Post-Covid-19 Crisis – Six Things to Do
Covid-19 is not the great equalizer, it’s the great revealer. It has revealed social and economic inequalities to the public. The silver lining of the pandemic is that the public can see this now.” — Edward Shin, MD, CEO & Co-Founder, Quality Reviews “Any individual in this pandemic, without healthcare, is a threat to all of […]
Key Considerations to Maximize 1115 Waiver Quality Performance: The Challenge, The Opportunity, The Future
With all of the challenges that 2020 has injected into health system operations and priorities, providers and payers are appropriately focused on Covid-19 prevention and treatment, organizational preparedness and mitigation of financial impact. Texas providers participating in the Medicaid 1115 demonstration waiver Delivery System Reform Incentive Payment (DSRIP) also have a unique opportunity in the […]
Observations and Post-Covid-19 Health Care in the United States
During the 20th century, two world wars and numerous regional military conflicts claimed more than 150 million lives and decimated entire countries. During the past 100 years, trillions of dollars have been expended assembling armies and building military preparedness to defend homelands and protect the citizenry. However, it has taken less than three months for […]
Evaluation of Care Management for the Uninsured
Background: In 2008, Kern Medical Center established a CareManagement Program (CMP) for low-income adults identified asfrequent users of hospital services. Frequent users are defined ashaving 4 or more emergency department (ED) visits or admissions,3 or more admissions, or 2 or more admissions and 1 ED visit within1 year. The CMP helps patients access primary care […]
Hospital COVID-19 Disaster Funding: Five Things Hospitals Must Do to Prepare
Hospitals, state associations and other stakeholders need to be prepared to address the negative financial impacts associated with the COVID-19 pandemic as it continues to have a widespread impact on our health care system. Many hospitals are likely to experience severe financial challenges, requiring financial assistance from federal, state and local governments in order to […]
Key Questions and Strategic Considerations for MCP Practices Over MCP End in December 2025
MCP practices should consider and begin to plan for a transition to enter the MSSP ACO program for 2026 and choose stable, long-term partners to take control over your VBP future. CHS can support you in your MSSP ACO journey through flexible partnership models that provide you with our expertise, analytics and operational support while […]
Despite Threats to the ACA, It is Time to Plan Long-Term
The Affordable Care Act (ACA) has survived for a decade despite Congressional attempts to repeal it, executive orders to weaken it, and some Democratic Presidential candidates proposing to upend it in favor of a single-payer system. Despite the political rhetoric and executive actions, participating ACA individual insurers experienced a highly profitable 2019. This resulted in […]
To Succeed at Managing Population Health, Adopt a Health Plan Mindset
Value-based payment models are forcing hospitals and health systems to assume increasing levels of financial risk, prompting many to adopt population health management as a means for controlling costs and improving patient outcomes. Many of these organizations are just beginning to explore the world of population health management, whereas others are increasing their investments in […]