The accelerating push toward value-based healthcare is driving market disruption: hospital mergers and acquisitions, payers purchasing providers, and retail giants with health clinics proposing to merge with or buy insurance companies. In this landscape of upheaval academic medical centers (AMCs), like other hospitals, must adapt or risk becoming obsolete. However, AMCs have unique characteristics that (…)
This three-part blog series covers why Medicare ACO participants need to formulate a long-term Medicare Advantage strategy. In this first post, we will discuss the proposed “Pathways to Success” program from CMS. CMS recently announced a long-awaited proposed rule to redesign the Medicare Shared Savings Program (MSSP), Medicare’s cornerstone initiative to reform the payment system. (…)
Our industry is changing at an unprecedented rate. Health systems must examine new ways of doing business in order to succeed in the years ahead. But how can health systems compete as consolidation, payer mix shifts, and vertical integration continue to disrupt the market? The shift from volume- to value-based care and the need to (…)
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 (…)