Fee-for-service revenue remains dominant among healthcare provider organizations, but leaders expect a shift to value-based payment models over the next few years. They are testing models such as shared savings, bundled payments, and shared risk. The true degree of risk in these arrangements is unknown, as are the specific outcomes of the different models. Financial executives are challenged to make the right bets and to be sure their organizations have the necessary skills. The coming years are a bridge between the fee-for-service present and the pay-for-...
M&A in the hospital and health system business used to be relatively simple: big hospital or system buys smaller hospital or system. But in 2015, as organizations nationwide try to navigate the vast geographic differences in the pace and nature of healthcare reform, their solutions are equally myriad. [Sponsored by Bank of America Merrill Lynch]
Clinical integration allows independent/private practice and employed physicians alike to jointly develop clinical initiatives with hospitals or health systems, aiming at patient care that's higher quality, more efficient, and less costly. These agreements also allow providers and care partners to formally align and collaborate on the critical requirements of care coordination: evaluation and concrete improvement of clinical performance, reduction of unnecessary service utilization, and management and support of high-cost and high-risk patients. According to...
The healthcare delivery system in the United States is under unsustainable stress. How can individual hospitals, health systems, and health plans adapt to current changes and prepare themselves for bigger shifts ahead? This broad topic was the subject of an extraordinary gathering in January 2015 of healthcare executives representing leading organizations from around the country. In a series of conversations moderated by HealthLeaders Media editors, these experienced leaders shared their organizations' strategies, opened up about their anxieties for the future,...
Healthcare leaders agree on the logic behind population health: that the focus of a care delivery system should be on keeping patient populations healthy rather than waiting to treat illness. Yet transitioning away from single-patient, episodic care is a major economic and organizational challenge for hospitals and health systems. They must revamp the roles of physicians, midlevels, and care team providers; implement data analytics solutions and learn to incorporate the findings; negotiate risk-based payment agreements with payers and partners—all at the same time...
The role of physicians is changing dramatically. Physicians today are being called on to help lead healthcare organizations through major changes that will impact patient care, cost, and outcomes, as well as be accountable for the business of healthcare. As clinical care becomes entwined with financial results, the chief medical officer is responsible for better results at the bedside and on the balance sheet. Because business skills are not taught in medical school, hospitals and health systems are filling the void with rigorous leadership programs that prepare...
