Finding a Partner with the Right Cultural Fit: 4 Strategies

by Meredith Inniger, Manager

Open PDF file > It’s healthcare’s version of dating: sizing up another organization for a potential partnership or merger. Seventy-one percent of healthcare leaders expect their organization’s merger, acquisition, or partnership activity to increase over the next three years. With continued changes to healthcare’s competitive landscape, hospital mergers and acquisitions (M&As) reached a record high […]

6 Big Changes in Proposed ACO Regulations

by John Harris, Director & Molly Johnson, Manager

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On August 9, 2018, CMS issued new proposed regulations for MSSP ACOs that, if finalized, will result in far-reaching changes in the program. The motivation for the proposed changes, which CMS calls “Pathways to Success,” is simple: CMS wants to move ACOs to risk more quickly. The great majority of 2018 participating ACOs are not […]

MSSP 2017 Performance Year Results and Pathways to Success: Implications for Track 1 ACOs

by Amanda Brown, Manager & Alexandra D'Innocenzo, Senior Associate

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Performance results were recently released for the 5th year of the Medicare Shared Savings Program (MSSP). These results show that a small but growing proportion of ACOs continue to earn shared savings from Medicare, as shown below. This data comes at a pivotal moment for Accountable Care Organizations (ACOs) as they rush to determine how […]

Putting Employed Physicians in the Driver’s Seat

by Rudd Kierstead, Principal

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As hospitals and health systems build their employed medical practices, a large emphasis is often put on compensation arrangements, and little attention is paid to engaging physicians in the successful management of these practices. At the same time, hospitals are experiencing significant operating losses for their employed practices. Losses vary, but hospital-owned practices typically lose […]

Involved in Value-Based Payment? Meet Quanto

by Amanda Brown, Senior Associate

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Veralon’s health system clients have achieved significant savings using Quanto to identify value-based improvement targets and provide the financial management reports to manage to those targets; client savings have varied from over $1 million to $13 million. Quanto was developed by Veralon and by Health Data Innovations, a leader in healthcare data integration. We partnered to make […]

Hospital Mergers and Acquisitions: Planning for Realistic and Achievable Results

by Robert Hill Jr., Principal

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A high volume of mergers and acquisitions between and among hospitals and health systems continue to dominate the healthcare landscape, with an increasing number of transactions anticipated in 2018.1 The benefits of consolidation are well known: Enhanced access to care and increased market share by providing specialty or subspecialty physician coverage previously unavailable or by […]

Using “Relative Burden” to Determine Reasonable ED Call Coverage Compensation

by Stuart J. Schaff, Senior Manager

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Many hospitals are finding themselves in discussions with physician specialists regarding compensation for emergency department (ED) call coverage. An increasing number of physicians are paid for this coverage, and information on these payments is becoming more widely available to physicians in the form of published surveys and conversations with fellow physicians. While healthcare finance leaders […]

What Does CVS-Aetna Have in Store for Hospitals?

by Scott Stuecher, Manager, Veralon

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Twelve years after launching the retail health insurgency with the purchase of the start-up MinuteClinic, CVS Health is upping the ante. In the biggest deal of 2017, CVS Health acquired Aetna in December. At this point, all predictions about how this merger will impact hospitals and health systems are conjecture. However, hospital leaders would be […]

ACOs: To Risk, Or Not To Risk?

by Idette Elizondo, Manager; Amanda Brown, Senior Associate;
& Alexandra D'Innocenzo, Associate

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Despite many uncertainties, the shift toward value based payment continues. More Medicare Shared Savings Program (MSSP) ACOs have entered risk-based tracks (Tracks 2, 3, and now Track 1+), to take advantage of MACRA’s[1] 5% bonus to physicians in risk-based payment models. The latest numbers about exactly how many have selected risk for next year will […]

Tackling the IT Challenge in Your CIN

by Molly Johnson, Manager & Alexandra D'Innocenzo, Associate

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Clinically Integrated Networks (CINs) need quality data to understand their patient population and manage provider practice patterns. That makes information technology (“IT”) critical at any stage of CIN development. For CINs with a mix of employed and independent physicians, IT is likely to be a tale of two cities – the employed physicians have solid, […]