You are here

Care Delivery

 

In 2014, Maryland adopted an all-payer, global budget program for most of its hospitals, making a fixed payment to facilities for services provided in inpatient, outpatient and emergency departments. In its first two years, the concept contained costs, but didn’t appear to change utilization by patients.

Seventeen more accountable care organizations (ACOs) have joined CMS’s Next Generation ACO model, the most advanced and high-risk available to ACOs in Medicare.

Intermountain Healthcare, Ascension Health, SSM Health and Trinity Health announced they’ll create their own not-for-profit generic drug company, called Project RX, with the goal of increasing pharmaceutical competition and making “essential generic medications more available and more affordable.”

Older diabetic patients are living longer as they and their physicians get better at managing the condition, but with longer lifespans comes additional years of incurring higher healthcare expenditures than non-diabetics.

The number of Americans without health insurance saw its biggest increase in nine years in 2017, rising 1.3 percentage points from the year prior, representing an estimated 3.2 million more people being uninsured.

 

Recent Headlines

Early Medicare ACO Results Mixed

According to the Centers for Medicare and Medicaid Services (CMS), one year into the Medicare Accountable Care Organization (ACO) initiative, a little less than half (54) of the 114 participating organizations have achieved savings and of those, just 29 saved enough money to receive “shared savings” bonuses. In addition, an in-depth savings analysis for the 29 participating Pioneer ACOs showed that nine achieved significant savings while also scoring high quality metrics.

21 Hospitals Enter Phase 2 in Bundled Prospective Payment Bet

Among the 232 health care providers that have entered into agreements in the now 1-year-old Centers for Medicare & Medicaid Services (CMS) Bundled Payments for Care Improvement initiative, 21 acute care hospitals have begun the second phase of the payment model that is the cleanest break with traditional fee-for-service.

Medicare Shared Savings ACOs: Crystal Run Shares Lessons Learned

Change isn’t easy, especially when it affects how much you are paid for services rendered. But the writing on the wall is clear: the fee-for-service model, especially for Medicare patients, is slowly but surely disappearing into the Affordable Care Act sunset. What’s a physician to do: work more and get paid less?

Supporting Value-based Care: UPMC’s Telehealth Strategy

Can a physician adequately serve multiple patients—in four or more different locations—in the same morning? Andrew R. Watson, MD, MLitt, FACS, knows the answer is yes because he has done it. Executive director of telemedicine for the University of Pittsburgh Medical Center (UPMC), and a practicing colorectal surgeon, Watson has found that his real world experience prepares him well for the naysayers—but patients are not among the skeptics.

Partner in Population-health Management: Walgreens, Anyone?

When Robert London, MD, received a phone call from an executive recruiter who suggested that he interview for a position at Walgreens, he was flabbergasted. “I wondered what I was going to do,” he recalls. “Would I stand at the door and greet people? Let them know about a new shade of nail polish?”

Peeling Off a Service Line How Hoag Reinvented Orthopedics

If Richard Afable, MD, MPH, president and CEO of Hoag Memorial Hospital Presbyterian, Newport Beach, California, told you he was closing down one of the largest orthopedics programs in California and entering into an orthopedics specialty hospital joint venture with his physicians, you might think about sending him job leads.

ACOs: Help or Headache?

Opinions about health care reform are plentiful, but Thomas H. Lee, MD, would rather hear solutions. When last year’s Affordable Care Act offered a new model called accountable care organizations (ACOs), Lee assessed the entity’s viability in his role as network president of Partners HealthCare System, based in Boston, Massachusetts.

Turnover and Retention Management in the Era of Reform

It's no secret that health care is undergoing tectonic changes, and as health care organizations struggle to keep pace with a rapidly evolving environment, there's never been a more critical time for the industry to develop and grow its competent leaders, says Tim Butler, senior consulting manager for GE Healthcare's Performance Solutions business.

Pages