Author: Bob Vernon, Senior Vice President, Lumeris Advisory Solutions

The COVID-19 pandemic has changed the landscape of healthcare dramatically. The pandemic has highlighted the challenges—and opportunities—across the industry: The fragile state of fee-for-service (FFS) and the limitations of the current financing mechanisms in healthcare The spike in demand for alternative care delivery sites such as virtual care and telehealth—and the need for a more (…)

For decades, the healthcare industry has struggled with how to best distribute risk and responsibility for financing healthcare costs. Downstream risk arrangements between health plans and providers first emerged in the 1980s and 1990s when insurance companies and health maintenance organizations began contracting with medical groups and independent physician associations using capitation and other risk-sharing (…)