Author: bkline

Creating a top tier health plan: What are the key drivers? – Part 2

April 23, 2019 | By

This Perspectives series looks at the challenges provider-sponsored health plans (PSHPs) can face. Part 1, Why Provider-Sponsored Health Plans Fail, examined the market dynamics motivating provider organizations to launch health plans. Part 2 discusses the need to focus on the key factors at launch that will drive success for a PSHP. When health systems look (…)


Mapping the Financial Journey for Health Systems

April 18, 2019 | By , , and

Health system executives understand the move to value-based care is here. But accepting that reality doesn’t answer their questions about when and how to transition from a business model based on fee-for-service payment to one based on payment for value—without degrading their organizations’ financials. To help answer those questions, we analyzed a large regional health (…)


How a Hospital or Health System Can Assess the Risk of Moving to Value-Based Payment

March 29, 2019 | By , , and

Health systems considering a strategic move away from the traditional fee-for-service (FFS) payment model to value-based payment approach can benefit from modeling the risks and likely effects of such a move. Health systems across the country are struggling to maintain their overall profitability and operating margins. Organization leaders realize they must take a hard look (…)


Beyond ACOs: Why Medicare Advantage Should Drive Your Risk Strategy

October 24, 2018 | By

This three-part blog post series highlights why Medicare accountable care organization (ACO) participants should evaluate Medicare Advantage as a longer-term strategy. In the first part, we covered the proposed “Pathways to Success” program from CMS, and the effort to push more ACOs into downside risk. In the second post, we discussed the limitations of the (…)


Trying to Accelerate the Move to Value? The Limitations of Medicare ACOs.

October 19, 2018 | By

Trying to Accelerate the Move to Value? The Limitations of Medicare ACOs Ben Kline, Vice President Strategic Partnerships This three-part blog series covers why Medicare accountable care organization (ACO) participants need to formulate a long-term Medicare Advantage strategy. In the first post, we covered the proposed “Pathways to Success” program from CMS. In this second (…)


Need to drive MA plan membership? Don’t ignore your Marketing and Sales strategy

September 13, 2017 | By

By Ben Kline, Business Development and Joel Andersen, Vice President, Marketing After considerable due diligence, your organization has decided to launch a Medicare Advantage (MA) plan. You evaluated the market and current MA enrollment. You examined market competitors, such as provider-sponsored organizations, regional insurance firms, and large national organizations. You gauged potential competitor responses, trying to figure (…)


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