by John Harris, Director
HFM blog
January 2014
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Today’s provider efforts to form clinically integrated networks (CINs) suggest clinical integration is gaining traction. Providers are starting to address the array of opportunities to improve care, lower cost, and receive the associated rewards. We have seen significant movement in five pillars of clinical integration. Payer Engagement Payers are focusing additional funds on value-based arrangements […]
by John Harris, Director & Idette Elizondo, Manager
HFM Blog
January 2015
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As a Zen master might say, “Change must come from within.” Everybody can point to fundamental problems with healthcare delivery, especially for low-income populations. But managed-care rewards and penalties and other efforts have not been enough to transform the delivery system. New York State is working to encourage “change from within” through its Delivery […]
by John M. Harris, Director & Idette Elizondo, Manager
HFM Blog
October 2014
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The number of physician-led ACOs is growing faster than the number of hospital-physician ACOs. Increasing numbers of physician groups are evaluating bundled payment arrangements. Payers are working directly with physicians on patient-centered medical homes (PCMHs). It appears that physician-led accountable care initiatives are here to stay. In some markets, physician-led networks may compete successfully by […]
by John Harris, Director & Karin Chernoff Kaplan, Director
HFM Blog
September 2013
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Of the 41,000 physicians in the 2013 MGMA Physician Compensation and Production Survey, 56 percent are employed by hospitals or health systems, compared with 42 percent in the 2010 survey. Conventional wisdom is that the remaining physicians will rapidly join the ranks of the employed. However, hospitals and physicians can explore many types of relationships […]
HSS Blog
August 2014
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Clinically Integrated Networks (CINs) and Accountable Care Organizations (ACOs) are vehicles for evolved forms of capitation that include value-based and risk sharing performance incentives, unlike past reimbursement models which focused primarily on utilization (see Figure below). Both aggregate and align providers, but differ in types of payors. ACOs are paid by Medicare and/or Medicaid, while CINs have commercial insurers. […]
by Jessica E. Stack, Karin Chernoff Kaplan, Stu Schaff
Healthcare Financial Management
August 2015
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A health system’s efforts in deploying strategic network initiatives will be effective only if its leaders understand the unique factors affecting multi-provider networks.