The Value-Based Enterprise Conversation Series: Informed

As the healthcare industry continues shifting to value-based care delivery, nurturing and maintaining an informed health system is more important than ever. Organizations that expect to thrive in this evolving environment must demonstrate an awareness of what they need to know now as well as in the future and possess the infrastructure to acquire and manage the continuous flow of relevant data. But being informed involves more than just gathering data; converting that data into actionable information and leveraging it to make clinical, operational, financial, strategic, and technological decisions is critical.

As part of our ongoing series of conversations about the value-based enterprise, Michelle Holmes, one of the leaders of ECG’s Healthcare IT practice, discusses the attributes of an informed healthcare organization and explores the technical and cultural barriers that often prevent organizations from making data-driven decisions. Continue reading

Is Your Orthopedic Service Line Positioned to Assume Risk for Joint Replacement Surgery?

Is your hospital prepared to bear financial risk among your Medicare patient population for total joint replacement (TJR) surgery?  Last week CMS proposed a Comprehensive Care for Joint Replacement (CCJR) model, scheduled to begin as early as next year. It is part of CMS’s ongoing effort to transition away from fee-for-service (FFS) payments and toward reimbursing physicians based on the quality of care they provide. Continue reading

Value-Based Enterprise Conversation Series: Responsive

In the era of health reform, new payment methodologies built around value and shared risk are replacing traditional fee-for-service reimbursement models. Shifting payment structures are symbolic of the changing healthcare landscape. Partnerships and mergers are reshaping local and regional markets; patients are expecting greater value, access, and transparency; and legislative and regulatory mandates – along with their associated opposition – are contributing to an air of uncertainty.

To survive, organizations must do more than simply react to the changing environment. Instead of being forced into action by external drivers, responsive organizations are proactively designing and executing near- and long-term positioning strategies. Leaders in these health systems understand the importance of responding quickly to changing market conditions, shifting payment models, and evolving patient needs.

As part of our ongoing series of conversations about the value-based enterprise, Terri Welter, head of ECG’s Contracting and Reimbursement practice, shares her thoughts on what it means to be a responsive organization in the era of reform. Continue reading

ECG’s John Fink Wins HFMA Award

Congratulations to John Fink on receiving the Healthcare Financial Management Association’s Helen Yerger/L. Vann Seawell Best Article Award for 2014-2015! John’s article, “Aligning with Physicians to Regionalize Services,” was published in the November 2014 issue of hfm magazine and can be viewed here.

John joins Kevin Kennedy and Dan Merlino as a recipient of this award, which garners national recognition for ECG’s outstanding thought leadership content.

The World of Reimbursement Is Changing: Is Your Practice Ready?

Faced with the dramatic escalation of healthcare costs, providers, commercial payors, and the government are testing different methodologies for reimbursing cancer care. The aim is to shift the economics from a fee-for-service environment to a value-based environment that rewards quality, efficiency, and a lower cost of care. However, simply acknowledging the evolving landscape will do little to help oncology providers in preparing and positioning themselves for the transitions ahead. Read this article by Jessica Turgon for Oncology Practice Management to learn about emerging reimbursement methodologies for cancer care and why oncology practices need to be responsive, rather than resistant, to these new payment arrangements.