David Williams

David is a partner and serves as the leader of healthcare reimbursement and advisory services. With more than 25 years of experience, David's practice is concentrated in the healthcare industry providing assurance, reimbursement and advisory services for a wide range of organizations including hospitals, outpatient centers, home healthcare agencies, skilled nursing facilities, assisted living centers, rural health clinics and mental rehabilitation centers.
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Recent Posts

June 07, 2018

How To Find the Upside in Downside Risk

Wary of factors that are outside their control, almost two-thirds of healthcare leaders would rather bail out of their accountable care organizations (ACO) than make the leap to a model that includes downside risk.

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Topics: Value-Based Care

August 25, 2017

Why Your Hospital or Physician Practice Must Embrace Risk

Risk tolerance is an interesting thing. Those who make the biggest bets often are actually control freaks—maybe because they know that, by having a strong grasp on the factors that influence the deal, they greatly increase the likelihood that they will come out ahead.

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Topics: Value-Based Care, Cost Accounting, MACRA Summary

May 25, 2017

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.

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Topics: Fee-for-Service, Value-Based Care

February 09, 2017

What Level of MACRA Investment Makes Sense for Rural Hospitals?

Rural hospitals have some tough decisions to make about their level of participation in the new CMS Quality Payment Program created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). 

For a number of reasons, the MACRA cards are stacked against small and rural providers. Given the limited number of Advanced Alternative Payment Models (APMs) that are being approved, many providers will start out in the Merit-Based Incentive Payment System (MIPS), and that track offers limited upside potential compared with APMs.

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Topics: Quality Payment Program, MACRA Summary

January 05, 2017

Medicare-Medicaid ACO Model: Urge Your State to Apply by Jan. 20

January 20 is a significant date for healthcare providers—but not necessarily for the reason you think.

Yes, there is the inauguration of the 45th President of the United States, who has vowed to “repeal and replace” the most significant healthcare legislation in recent history.

But that date has even greater significance for the many providers across the country who are struggling to cover the cost of care of an increasingly high-risk, low-income population.

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Topics: Healthcare Reform, APMs, MIPS and MACRA, MIPS CMS

November 18, 2016

New Bill Proposes Expanded Telehealth Services for Hospitals & Healthcare Providers

Virtual healthcare is a godsend to struggling healthcare systems as they try to offer the right care in the right setting. Every day, these systems face enormous pressure to provide both high-quality and cost-effective healthcare to their communities. Their clinics are filled with scheduled patients, while others wait for a “work in.”

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Topics: MIPS Healthcare, MACRA Summary

April 28, 2016

The Shifting Role of the Rural Hospital

Here’s a potentially disturbing statement: “Rural healthcare needs healthcare – not buildings.”

I’ve been watching rural hospitals closely as they cope with the changing healthcare landscape, and I’ve come to believe this statement is true. You might find it disturbing because of its implications – if rural hospitals don’t need buildings, what happens to their staffs, their service, their presence in the community and their stakeholders? And most of all, without a physical presence in a community, what happens to urgent care and its lifesaving role in rural areas? 

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Topics: Rural Health Care, Affordable Care Act Summary, Value-Based Care

March 24, 2016

Is Your System Heading for Success or a Crash?

I recently saw an excellent example of offering appropriate care in the appropriate setting when I reviewed my new HORNE healthcare plan. HORNE is offering a new program called “MD Live.” For the first time, our insurance will cover employees who consult a doctor remotely by using a phone, tablet or computer. The next time I feel a cold or the flu coming on, I can visit with a doctor and get the treatment I need without traveling to the doctor’s office. 

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Topics: Healthcare Quality, Population Health, Patient Care, Hospital Management

August 06, 2015

Why Healthcare’s Headed for a Crash and How it Can Transform

Have you taken a look lately at the statistics that tell the story of the future of health care in the U.S.? It’s sobering. The outdated payment model is just one part of the challenge. Between baby boomers retiring and overloading the system with aging patients that need more care, and the doctor pipeline dwindling, there is a fundamental need to change the delivery model before it crashes. 

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Topics: Quality Improvement

February 04, 2015

3 Key Themes from Day 2 at AHLA Physicians and Hospital Law Institute

On Day 2 at the AHLA Physicians and Hospital Law Institute, three themes ruled the day. Here’s a quick recap:


A technology driven revolution is taking place in healthcare. The traditional patient/physician relationship is changing, and consumer demand will cause telehealth to become mainstream healthcare.  Remote access and patient monitoring will become more prevalent. Access to care will improve, as it will be available in locations where it is limited, or doesn’t exist, today.
The Federation of State Medical Boards (FSMB) has adopted the “Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine.” Leadership in your facilities should be familiar with FSMB policies.   

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February 03, 2015

10 Takeaways from Day 1 at AHLA Physicians and Hospitals Law Institute

Act Now to Increase Your Odds of Success

Yesterday, the HORNE Healthcare team made notes of key points in sessions with over 400 of the nation’s leading healthcare attorneys. The presentations reinforced the idea that disruptive change is creating opportunities in the industry:

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January 08, 2015

2015 Challenge for Hospitals – How to Simplify and Stay Relevant

The mindset of many hospitals over the last several decades has been to be everything to everyone. There was a desire to create a complex organization offering many different services. The challenge with this organizational philosophy is multi-fold, especially for rural hospitals that find themselves funding specialty services that are low in demand, sometimes at the expense of serving more pressing needs of their community.

Hospitals might want to take a page from the Proctor & Gamble playbook that changed from offering many different products in many different sectors to a simplified offering of their most profitable and targeted product lines. You can read more about it here in an interesting post on the story and its lessons for hospitals.

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December 30, 2014

Resources to Help Healthcare Leaders Plan for Success in 2015

Nearly a year ago, we started our conversation on this blog about the big ideas and important news driving big changes in healthcare delivery. There are many challenges to face, but also many opportunities that can be mined. It’s an exciting and pivotal time for healthcare leaders and our goal remains the same as we approach 2015: to help our clients meet the future armed with the information that matters.

As you look toward leading your organization into the new year, here is a resource center of articles to help you move your workplace culture forward, note important regulatory deadlines and stay compliant, and secure patient health information (PHI). We look forward to continuing to bring you the resources you need to make informed decisions that protect and grow your organization. Happy New Year from our team to yours!

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Topics: Hospital Management