Turning Conflict into Collaboration: How to Manage Workplace Disagreements

Post on June 28, 2019 in Insights, and Lumina Leadership Institute

Healthcare organizations are experiencing change at a rapid pace as technological innovations and alternative payment models greatly impact operations—and people. As a leader, you can expect these changes to create workplace conflict. But you also should be assured that you can manage this conflict, and make it a productive rather than disruptive force, by using ...Read More

What’s the Blueprint for Taking on Risk?

Post on June 25, 2019 in Insights, and Value-Based Strategy

Although the healthcare trend is shifting risk to providers, health plans have important roles to ensure both parties succeed. Although provider risk needs include a blueprint to prepare and engage in risk-based contracts, health plans can help determine success by sharing knowledge and insight with them, said Meredith Duncan, executive director and COO of Aetna’s ...Read More

Reducing Clinical Variation to Drive Success in Value-Based Care, Part 2

Post on June 19, 2019 in Clinical Transformation, and Insights

Previously, we examined the issue of clinical variation reduction in terms of the stakes for value-based care. We also discussed two vital strategies for reducing clinical variation: physician engagement and implementation of risk-based analytics. Below, we describe two more key aspects of initiatives to reduce clinical variation. Deployment of Physician Scorecards Physicians, like most people, ...Read More

How Physician-Finance Partnerships Pave the Way to Higher-Value Care

Post on June 6, 2019 in Insights, Lumina Leadership Institute, and Value-Based Strategy

In the past few years, a growing number of physicians have taken leadership roles in hospitals and health systems. Given that value-based care is a team sport, this is a positive trend. Yet conflict between physicians and finance executives can arise because of their respective knowledge gaps and differing perspectives and work styles. To work ...Read More

7 Winning Strategies for CMS’s MSSP Pathways to Success, Part 1

Post on April 29, 2019 in Insights, and Value-Based Strategy

The decision about whether to participate in the Centers for Medicare and Medicaid Services’ (CMS’s) new Medicare Shared Savings Program (MSSP), Pathways to Success, is complicated. It requires a detailed understanding of the rules of the program, your patient population, as well as your level of maturity with several key population-management capabilities (e.g., care management, ...Read More

Patient Risk Scoring Is the Key to Value-Based Payment

Post on April 25, 2019 in Insights, and Value-Based Strategy

The U.S. healthcare system is steadily transitioning from fee-for-service (FFS) reimbursement to fee-for-value (FFV) payment. This change has already started to affect medical practice revenue, and it will have an even bigger impact in the years ahead. Unfortunately, most physicians and practice managers understand only part of the FFV equation. While they know the quality ...Read More

Top 7 Healthcare Trends Include a Focus on Risk, Development of Physician Leaders

Post on April 8, 2019 in Clinical Transformation, Digital Innovation & Analytics, Insights, Lumina Leadership Institute, and Value-Based Strategy

Nearly every aspect of the healthcare world is changing―constantly, unpredictably, and quickly. As stakeholders navigate their various paths, knowing what to expect can help with decision making about compliance, risk, cost, and more. We have identified 7 areas that healthcare leaders must navigate to stay ahead of change and remain agile, effective, and profitable. 1. ...Read More

A Blueprint for Building a ‘Risk Ready’ Healthcare Organization

Post on April 1, 2019 in Insights, and Value-Based Strategy

Facing growing pressure from insurers to assume more financial risk, healthcare providers are exploring ways to better manage cost and utilization through risk-based contracts. Unfortunately, the approaches these organizations have adopted are too often inadequate, because their executive teams are giving most of their attention to the contract itself and not enough thought to what ...Read More

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