Risk Management
The nature of the risk under the CMS Pioneer ACO and Shared Savings programs is hard for providers to manage. But the Next Generation ACO program has changed the level of risk, offering providers a higher share of savings and new ways to limit unpredictable losses.
With the Oncology Care Model, participating practices will have their chemotherapy treatments tracked and measured for the necessity and outcome of the treatment, as well as the coordination of care that leads up to the cancer treatment.
The parent health system of Massachusetts General and Brigham and Women's hospitals lost $17.5 million in the three months that ended March 31, as the winter's 9 feet of snow kept some patients from coming into the hospitals and clinics.
Given the shift of healthcare resources to primary and preventive care, there are real, long-standing problems with the health insurance model that could be solved uniquely when the payer is owned by the provider business getting paid.
American Medical Association says the readmission penalty is unnecessary since other other pay-for-performance programs already measure complications such as surgical site infections.
With out-of-pocket costs for patients increasing due to the popularity of high deductible health plans, and with so few purchasers taking advantage of health savings accounts, the risk of bad debt and charity care has increased for healthcare providers.
While once there were no books, conferences and even curriculum dedicated to the management methodology, now there are dozens of tools available.
Organizations need to find ways to increase collections on the front end, revise charity policies and contract for shared risk to stay solvent, according to a new report from iVantage Health Analytics.
Security spending geared towards better locks, security staff and more cameras, but the most important spending is on risk assessment and staff training.
Texas health system offering patients more choice and nurturing its own health plan, even while collaborating with major insurers.