Topic:

Show All

Jun 15, 2017 10:00:00 AM

A Primer on Operationalizing Alternative Payment Models

MACRA’s anticipated future impact on the healthcare industry has many provider organizations contemplating what actions and resources are necessary to participate in alternative payment models (“APMs”). Provider organizations facing the immediate options of getting involved with a CMS or commercial APM have significant operational decisions to make that will impact the future make-up of their organizations. Today we will discuss some of the considerations in preparing for APM participation.

Continue reading >

Topics: MACRA, CMS, APMs, Alternative Payment Models

Jun 9, 2017 9:00:00 AM

Activity-Based Costing: The Rock Star of Payment Model Reform

Think you can’t afford to invest in a cost-accounting system? The truth is, you can’t afford not to. As Medicare and other payers increasingly tie payments to value, understanding and reducing your cost structure will become an even more urgent priority.

Continue reading >

Topics: Medicare, Cost Accounting, Payment Model Reform

Jun 1, 2017 11:30:00 AM

CHNAs—Take Them off the Shelf

Community Health Needs Assessments (CHNA), unfortunately for many, are conducted simply to fulfill the Section 501(r) of the Internal Revenue Code which requires a tax-exempt hospital to conduct a CHNA. Also, community health assessment is a prerequisite of public health accreditation under PHAB standards. As we have discussed in a previous blog, a hospital’s CHNA can achieve so much more than fulfilling a regulatory obligation.

Continue reading >

Topics: CHNA, Community Health

May 25, 2017 10:00:00 AM

A Prescription for Reviving Your Financial Outlook: A Medicare Risk Strategy

Healthcare providers face $42 billion in cuts in 2018 under Medicare’s traditional fee-for-service program. Those payment rate reductions, which were put in place by the Affordable Care Act, are scheduled to cut deeper with each year—from $53 billion in 2019 to $86 billion in 2022.

Continue reading >

Topics: Medicare, Fee-for-Service, Value-Based Pay

May 19, 2017 11:00:00 AM

Lessons Learned From the WannaCry Ransomware Attack

Last week, the WannaCry ransomware attack hit over 150 countries and infected tens of thousands of systems worldwide. Among those victimized were England’s National Health Service, automobile manufacturers, and government systems. The worm’s ominous red ransom screen, informing the user that all files have been encrypted, was found on only on users’ desktops, but also on ATM screens, parking meters, digital billboards, and industrial control systems.

Continue reading >

Topics: Cybersecurity, Ransomware, WannaCry

May 11, 2017 3:00:00 PM

How To Get Started on the Journey to Population Health

For many healthcare organizations, the long-term vision for population health is clear: Deliver better care at a lower cost, ultimately improving the health of the populations they serve. But the potential paths that lead to that shared destination are about as varied as the number of organizations that seek to reach it. How do you know where to start?

Continue reading >

Topics: Population Health

May 2, 2017 10:00:00 AM

Would Trump Tax Plan Trigger Entity Restructuring for Medical Practices?

President Trump’s vision for tax reform has raised more questions than answers. Just one of these provocative questions is how a 15% corporate tax rate—which would apply to pass-through income as well as corporate earnings—would affect physicians and other business owners.

Continue reading >

Topics: Tax, Tax Planning, Trump

Apr 28, 2017 10:00:00 AM

MedPAC to US Congress: Act Now to Reform Post-Acute Payments

The post-acute care (PAC) sector is a target for significant change. Facing criticism of excessive spending, the sector is facing an overhaul of the payment system that, when it finally arrives, could disrupt the healthcare landscape once again.

Continue reading >

Topics: MedPAC

Apr 20, 2017 2:30:00 PM

In Latest Report, MedPAC Reiterates Call to Equalize Payments

With health care spending growth still increasing, the Medicare Payment Advisory Commission (MedPAC or the Commission) continues to pursue its mission to advise US Congress on the Medicare program and its costs, which ultimately are borne by all taxpayers.

Continue reading >

Topics: MedPAC, Reimbursement

Apr 14, 2017 10:30:00 AM

Appealing to the New Healthcare Consumer: Use Your Data

As high deductibles and escalating costs drive patients to take a more active role in their health care, providers are waking up to the fact that they need to pay attention to what buyers want. But uncovering those consumer insights and using them to drive organizational strategy remains a challenge for most providers.

Continue reading >

Apr 6, 2017 10:00:00 AM

Data Security Hygiene Practices for a Healthy Practice

One of the first words that come to mind when I think of medical care is hygiene. Let’s face it, poor hygiene practices in a healthcare provider’s facilities can cause major issues and possible loss of life. Consumers of healthcare services, trust that their provider is taking every precaution possible to protect them from disease or infections that can occur if proper hygiene is not practiced. 

Continue reading >

Topics: Healthcare, Data Security

Mar 31, 2017 10:00:00 AM

3 Insights from AHLA’s Institute on Medicare & Medicaid Payment Issues

Last week’s sudden pull of the American Health Care Act from House vote caused uncertainty around what’s next for the healthcare industry. This week, the AHLA Institute on Medicare and Medicaid Payment Issues, brought together key representatives from CMS, hospital associations and healthcare lawyers from around the nation. Here are three Medicare/Medicaid insights on current and upcoming issues:

Continue reading >

Topics: Medicare, AHLA, CMS, Medicaid

Mar 30, 2017 3:00:00 PM

How Do Recent Settlements Give Insight into Effective FMV and CR Compliance Programs?

As discussed frequently in compliance and health care conferences and forums and on this page, fair market value (FMV) of payments to referring physicians is an essential compliance requirement of the Stark law and federal anti-kickback statute. Physician compensation in excess of FMV is at the crux of much health care enforcement activity. As noted by Richard Kusserow, former Inspector General, “Arrangements with physicians are the highest compliance risk area in 2017” (“Kickback Cases Remain Top DOJ and OIG Priority in 2017,” Strategic Management Services, LLC; Jan. 2017). Mr. Kusserow further explained that whistleblowers are a significant source of enforcement activity.

Continue reading >

Topics: FMV, Compliance, CR