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

Real Versus Perceived Need: Barriers to Success for Digital Health Innovation

Post on March 18, 2019 in Digital Innovation & Analytics, and Insights

Recently, I had the pleasure of spending some time with Kiri-Maree Moore, CEO and founder of Decision Velocity Global. As an adviser and strategist, Moore works with organizations to help develop sustainable and scalable ecosystems that help them meet their strategic goals while adding value to humanity. One of the core values of Moore’s brand ...Read More

How to Achieve a Return on an EHR

Post on March 1, 2019 in Digital Innovation & Analytics, Insights, and Value-Based Strategy

In the past decade, many large-scale EHR implementations have led to drops in revenue and operating income, and reductions in physician productivity have been one factor in these declines. Faced with negative ROI on a sizable investment, many organizations have responded by attempting to rebuild productivity through targeted initiatives. Common efforts include provider training, EHR ...Read More

New MSSP Rule: Leveraging Analytics Best Practices to Measure and Predict ACO Performance

Post on February 12, 2019 in Insights, and Value-Based Strategy

The Centers for Medicare & Medicaid Services (CMS) published its Medicare Shared Savings Program (MSSP) final rule in December 2018, and the final rule overhauls the MSSP and takes a new approach to transitioning providers to performance-based risk arrangements under accountable care models. A National Association of ACOs survey released in May 2018 indicated that 71 percent of the ...Read More

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