3 Ways to Build Relationships with Physicians Now

by Karin Chernoff Kaplan, Director
and Rudd Kierstead, Principal

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Many independent physicians are financially challenged as the COVID-19 impact continues. Some may find employment or other alignment opportunities attractive now, even if they have not shown interest in the past. Health systems that work to develop relationships with these physicians now will be at an advantage.

Interactions of Medicare Alternative Payment Models

by John Harris, Director
and Amanda Brown, Manager

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CMS continues to authorize voluntary and mandatory alternative payment models (APMs) to shift risk to providers. Beyond choosing which models offer the best opportunity, providers must evaluate the impact of participating in multiple APMs simultaneously. Overlapping APMs can be synergistic or self-defeating. Where simultaneous participation is an option, overlapping incentives are complicated and may not […]

Why It May Be Time for Health Systems to Restructure their Physician Enterprises

by Daniel M. Grauman, Managing Director & CEO
and John Harris, Director

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Even before the pandemic, the median loss per physician employed by a hospital or health system totaled more than $278,000. Now, as hospitals face their biggest financial crisis ever, hospital leaders must consider: “Is there a better structure for our physician enterprise?” The pain points that hospitals and physicians experience under an employed physician enterprise […]

Choosing the Optimal Strategic Relationships

by Mark Dubow, Director
and John Harris, Director

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Your organization’s near-term success is dependent on emerging from COVID in full sprint to address critical strategic initiatives and new opportunities. Strategic relationships can provide access to capabilities, expertise and speed to market that are superior to a “build” or “buy” approach. While traditional relationships (other hospitals/systems, health plans, etc.) offer a degree of support, […]

5 Key Benefits of a Service Line Management Structure

by Lynda Mischel, Principal
and Meredith Inniger, Manager

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Often service lines are just a marketing tool, branding assorted practices as a specialty service line without connecting the services in a meaningful way. By establishing a management structure for service lines, hospitals and health systems can create an organized system of care for patients to progress smoothly from service to service. As health systems […]

Taking Virtual Meetings to the Next Level: 7 Tips for Facilitation

by John Harris Director
and Meredith Inniger, Manager

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Are you deciding whether to hold a virtual retreat/meeting or to postpone until it can be in person? Virtual retreats can be very effective, preparing your organization for quicker action when the pandemic clears. Remote meetings will continue well into 2021, and maybe beyond as work models and meeting expectations shift. How can you effectively […]

3 Questions Every System Should Answer Following the Medicare Hospital Outpatient Prospective and ASC Payment System Final Rule

by Lynda Mischel, Principal
and Meredith Inniger, Manager

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One of the most impactful final rules released by CMS in recent months is the CY 2021 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS-1736-FC). This rule includes several important policy changes, most notably the elimination of the Inpatient Only List on a phased schedule through CY2024 (when […]

Radiation Oncology Alternative Payment Model: 3 Things to Do Now

by Lynda Mischel, Principal
and Scott Stuecher, Manager

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CMS is launching a Radiation Oncology Alternative Payment Model (“RO Model”) that will profoundly affect radiation oncology economics, with a target start date of January 1, 2022. The RO Model will apply (or at least test) a bundled payment methodology affecting about 30% of eligible radiation oncology episodes. Revenue reductions may be as high as […]