A forward-thinking financial model can help hospital leaders better predict and balance potential gains and losses from incentives, penalties, volume changes, and other factors related to value-based payment.
After a long delay in publishing guidance for the 2019 Medicare Shared Savings Program (MSSP) application cycle, CMS issued a proposed rule on August 9, 2018, featuring significant revisions to the program.
Get to know ECG principal Terri Welter, head of the Managed Care Services Division. Hear Terri's perspective on the managed care side of healthcare and learn about her work as a consultant.
Many healthcare leaders bemoan the lack of certainty in healthcare today, but there are some trends that hospital and health system leaders can count on to shape the industry in the coming years.
PSAs provide hospitals and health systems a convenient and highly flexible mechanism to obtain services from physicians and achieve care coordination, access, and alignment goals. How can we make them sticky?
As baby boomers are reaching retirement, and the general population is living longer with more active lifestyles, the projected number of total knee arthroplasty (TKA) and total hip arthroplasty (THA) procedures for the Medicare and commercial patient population is expected to increase. Removing total joint procedures from the inpatient-only list enables cost reduction that results from performing these cases in the outpatient setting.
Although the primary driver of reclassification is typically the positive impact on clinical payments, there can also be significant implications for the hospital’s graduate medical education reimbursement.
CMS has finalized the CY 2018 Hospital Outpatient Prospective Payment System (OPPS) rule, confirming changes to the 340B Drug Pricing Program that were proposed earlier this year.
Surgical care is increasingly shifting to the outpatient setting, fueled by numerous factors that include clinical and technological advances, cost savings, and convenience.
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