Daniel Marino, managing partner, and James Grana, chief analytics officer for Rush Health, will present “Creating an Analytics Ecosystem to Drive Optimal Performance in a Risk-Based World” on Tuesday, June 25, 2019 from 1:30 to 2:30 p.m. at HFMA’s Annual Conference in Orlando. Learn more and register here.
As ACOs across the country consider the new CMS program “Pathways to Success,” leaders are beginning to ask questions about how to be successful in this new plan. Few ACOs will be able to remain in the program and avoid downside risk over the next one to three years. CMS is clearly prioritizing the shift ...Read More
Daniel Marino, managing partner for Lumina Health Partners, and Meredith Duncan, executive director and COO for Aetna, will present “Building the Blueprint to Support Risk-Based Contracts” on Sunday, June 23 from 12:30 p.m. to 3:30 p.m. at HFMA’s 2019 Annual Conference. Learn more and register here.
Financial challenges again rank No. 1 on the list of hospital CEOs’ top concerns, according to the American College of Healthcare Executives’ annual survey of top issues confronting hospitals. In addition, Moody’s recently confirmed its negative outlook for nonprofit hospitals, citing weak volume, reimbursement constriction, and increased numbers of Medicare patients. Financial issues are especially ...Read More
With recent changes to the Medicare Shared Savings Program (MSSP), all accountable care organizations (ACOs) need to pay closer attention to their compliance obligations and be prepared to make changes quickly. Each time the Centers for Medicare and Medicaid Services (CMS) updates its MSSP rules, as it did in 2016, it frequently follows these changes ...Read More
On Dec. 21, the Centers for Medicare and Medicaid Services (CMS) announced its final rule overhauling the Medicare Shared Savings Program (MSSP) to fundamentally change the way ACOs share in savings and take on risk. The new program, called Pathways to Success, contains several significant changes that ACOs will need to address. These include moving ...Read More
At Lumina Health Partners, we are committed to our core values of integrity, collaboration, value-creation, and generosity through social impact. We believe investments in programs that provide women with opportunities to better their health, education, and gain financial independence have effects beyond an individual. A woman business owner has the capacity to multiply the impact ...Read More
The Centers for Medicare and Medicaid Services’ (CMS) Physician Compare website helps beneficiaries find and compare physicians and other clinicians who are enrolled in Medicare, allowing individuals to make informed healthcare decisions. We all know how important it is for clinicians to maintain a positive reputation on social media and websites like Physician Compare. Before ...Read More
Hospitals, health systems, and physician practices must find ways to adapt to the quickly changing market forces around them. Sources of change include value-based contracting, provider competition, consumerism, changes in government and commercial payment models, health system regionalization, government regulation, and technological innovation. Health systems and physicians increasingly are finding it in their best interests ...Read More
Several years ago, I was working with a client reviewing quality and cost measures when we identified an individual who was a “frequent flyer,” or high utilizer, of the emergency department (ED). Upon further investigation, we learned that this person was seeking shelter and a hot meal, and he found the ED to be the best place to access both. ...Read More
Hierarchical Condition Code (HCC) risk-adjustment models are used to calculate risk scores, and these scores are becoming more important as hospitals and health systems embark on the journey to value-based care. Join us as Lumina’s Managing Partner Lucy Zielinski and Managing Principal Douglas Ardoin, MD, explore the coding, clinical operations, and data analytics aspects of ...Read More
Principal and Chief Digital Innovation Officer Shaillee Chopra will present “Developing an Actionable Analytics Framework to Support a Value-Based Care Contracting Strategy” on Feb. 21 at the Oregon Chapter of HFMA’s Winter Conference. Learn more here.