Case Study: Developing a Growth Strategy for a Clinically Integrated Network



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This clinically integrated network (“CIN”) had a track record of success, but was still leaving money on the table. Did they need to achieve formal CIN designation? Would one model of physician participation accommodate all types of interested physicians? Contact our Thought Leaders: John Harris, Managing Director, jharris@veralon.com Molly Johnson, Consultant, mjohnson@veralon.com

Case Study: Developing a Regional Oncology Program

by Mark Dubow, Director

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Challenge: Design a strategy to become the market leader for oncology services across a broad region that accounted for implications of emerging trends specific to: incidence of tumor sites, population, evolution of care, competitor vulnerabilities, and oncology reimbursement.   Contact our Thought Leader: Mark Dubow, Director, mdubow@veralon.com

Responding to 5 Competitive Threats to CINs

by Molly Johnson, Consultant

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Health systems and their Clinically Integrated Networks (CINs) face threats from a variety of competitors, including market disruptors, that may lure away aligned independent physicians and patients. Although the landscape of these competitors differs by market, they threaten the core business of CINs and complicate health system alignment with independent physician groups. Contact the Author: […]

6 Key Elements of a Physician Strategy

by Mark Dubow, Director
and Rudd Kierstead, Principal

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As health system physician enterprises have grown, addressing their challenges are central to health system success. Engaging physicians and supporting health system goals requires a cohesive approach.   Contact the Experts: Mark Dubow, Director, mdubow@veralon.com Rudd Kierstead, Principal, rkierstead@veralon.com

3 Ways to Use Hospital Price Transparency Data for Competitive Advantage

by John Harris, Director
and Clare O'Mara, Senior Associate

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Shifting a $1 trillion dollar industry from confidential contracts to publicly published pricing is a massive transformation. In the middle of recovering from the COVID-19 crisis, hospitals are responding to this transformation. Background: The hospital price transparency rules require consumer-friendly tools to help individuals shop for hospital services based on price. They also require hospitals […]

3 Key Factors to Analyze as Cardiac Procedures Move to Outpatient

by Mark J. Dubow, Director
and Ross Shuster, Manager

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By recategorizing procedures previously designated inpatient only, CMS is actively redirecting a significant number of cases to Hospital Outpatient Department (“HOPD”) and community-based ambulatory surgery center (“ASC”) settings. We have discussed the impact this will have on outpatient surgery, and strategies to prepare. This outpatient shift will also affect cardiac services, creating both risks and […]

Launching a Community Oncology Center: 5 Key Considerations

by Meredith Inniger, Manager

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Rapid evolution in diagnostics and treatment for cancer care, innovation through genomics and predictive analytics, the continuing shift toward value-based care are hastening the migration of oncology from hospital settings to community-based centers.  This raises the question: Is now the right time to invest in a community oncology center? The experiences of multiple health systems […]

The Surgery Shift from Inpatient – Assessing the Financial Impact

by Mark J. Dubow, Director
and Meredith Inniger, Manager

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Surgery has long been a key driver of hospital profitability. Effectively handling the new Medicare outpatient surgery rule[1] and subsequent care shift to outpatient settings is critical to long term financial success. This rule includes several important policy changes, most notably the elimination of the Inpatient Only List on a phased schedule through CY2024 when […]

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.