Authors: Nigel Ohrenstein, Senior Vice President and Head of Market, Lumeris Jordanna Davis, President, Rockingstone Group The Center for Medicare & Medicaid Innovation (CMMI) recently announced its latest value-based initiative, Direct Contracting (DC), a program designed to help providers shift toward delivering high quality, cost-effective care. Building on learnings from prior programs, Direct Contracting opens (…)
Is your organization considering applying for CMS’ Direct Contracting Program? As currently proposed, this new model offers significant financial, regulatory and operational advantages over previous CMS programs. The time is here to begin a robust transition to risk-bearing models, and Direct Contracting could be an important part of your system’s strategy. Read this new paper (…)
CMS recently announced the “Request for Applications” for its new Direct Contracting (DC) program. As currently proposed, the program offers a potentially market share-shifting opportunity that could change how FFS Medicare is delivered. While this is not a mandatory program, this is a key time to consider competitor actions that could impact your future Medicare (…)
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 (…)
We’re Sandy Shroyer and Julie Spalding, colleagues at Lumeris. We recently attended Modern Healthcare’s Women in Leadership conference in Chicago and found it to be inspiring, with outstanding speakers, great content, and lots of networking opportunities. These are our top takeaways as they relate to our career paths. Sandy: Having over 30 years of healthcare (…)
I’m protected! I’ve amassed a massive “clinically integrated” group of physicians and provider entities! As one of the central strategic initiatives of nearly every hospital and health system today, physician alignment has captured the minds, time, and attention of healthcare executives around the country. The healthcare industry has evolved—new entrants, massive consolidation, and payment reform (…)
When developing value-based care strategies, employer groups—particularly large employers—in your community must be included in your approach. From 2013-2017, employers’ healthcare costs increased on average 3.9% each year versus an average of 3.1% annual growth for the US GDP per capita. Further, employers have not found much relief in working with their plans to manage (…)