Philip Ikoku and Dan Juberg, Strategic Partnerships, Lumeris The not-for-profit health system sector was already battling a business model under significant pressure. And then along came 2020. Between COVID-19, ballooning unemployment, and a sharper focus on inequity, 2020 has reinforced healthcare’s ever-present quagmire: a system where society expects an efficient and streamlined industry, but with (…)
Provider-sponsored health plans and Medicare Advantage are gaining traction as a critical strategy for profitable, value-based care. However, many provider organizations underestimate the necessary lead time and effort required to move from consideration to activation. Planning for a 2021 launch needs to begin now starting with a detailed market and organizational feasibility study for standing (…)
Increasingly gloomy credit rating forecasts threaten to cast a cloud over the not-for-profit health system sector[1]. Traditional business models are under serious pressure and as value-based care and payment accelerates into an unavoidable but crucial strategy, these are the questions progressive Board Members are asking themselves: 1. What resources are dedicated to managing risk today (…)
Throughout this Perspectives series, we have examined why healthcare organizations should move to value and incorporate Medicare Advantage into their strategy. In this third and final segment, we discuss challenges with operating a Medicare Advantage plan and the critical elements for success. Medicare Advantage (MA) is proving to be an essential and growing component of (…)
Provider Sponsored Plans and Medicare Advantage are gaining traction as a critical strategy for profitable, value-based care. However, many underestimate the necessary lead time and effort required to move from consideration to activation. Planning for a 2019 launch needs to begin now starting with a detailed market and organizational feasibility study for standing up a (…)
Though MACRA and regulatory forces are encouraging providers to adopt value-based care delivery, many remain on the sidelines. Many are hesitant to begin this transition to managing risk; others simply ignore it at their own peril. Written By: Dan Juberg When the Centers for Medicare & Medicaid Services (CMS) proposed its new payment framework that (…)