Placing a Premium on AMC Performance

This blog post was written by Christopher Collins, Principal, and Dan Harrison, Senior Manager.

The clinical enterprise is the economic engine of an academic medical center (AMC). By clinical enterprise, we are specifically referring to the academic health system (AHS), which is the combined assets of the teaching hospital, the clinical faculty, and the affiliated or owned nonacademic (or “community”) physicians.

AMCs are built around the tripartite mission of delivering exceptional clinical care, advancing research, and educating the next generation of providers and researchers. Yet, research and teaching programs within AMCs are increasingly unable to sustain themselves through their traditional revenue streams. As a result, an alternative means of investment is required to sustain and grow these critically important programs, and the only remaining means of generating a predictable and healthy margin is through the performance of the AMC’s clinical assets.  This critical source of funding may be at risk, though, for organizations that are not strategically and organizationally well positioned. Continue reading

Build, Buy, or Align – Creating Integrated Health Systems for Value-Based Care

Healthcare organizations need to pursue clinical integration if they expect to flourish in an environment defined by value-based reimbursement. Organizations that lack a comprehensive portfolio of clinical service offerings risk losing ground to health systems that are better able to control costs and keep patients from seeking care outside a tightly integrated network.

In a previous blog post, we examined the first steps on the path to clinical integration – in particular, identifying gaps in service. Once providers identify those gaps, a bigger decision looms: how to fill them. This post considers the options. Continue reading

Before You Build, Buy, or Align – What Every Organization Should Know

As the healthcare industry continues moving toward value-based care delivery, provider organizations can no longer afford to think about clinical integration in the abstract. Thriving in a dynamic reimbursement environment characterized by alternative payment models requires strategic, financial, and clinical integration across a full continuum of healthcare services. Organizations that cannot offer a comprehensive suite of services to their patients could soon find themselves at a competitive disadvantage.

The critical question facing the leaders of those organizations is: “Do we build, buy, or align with existing organizations to provide missing services?” The answer will vary across providers and markets. But before that question can even be asked, organizations need to get a better grasp their existing capabilities and the dynamics of their markets. Continue reading

CMS Looks to Integrate Clinical and Community Care

The Accountable Health Communities (AHC) model, announced by the Centers for Medicare & Medicaid Services (CMS) in January 2016, is a pilot program that aims to link clinical care with community resources. With this model, CMS aims to improve overall care by steering Medicare and Medicaid beneficiaries to social services available in their communities.

Today we talk with Senior Manager Emma Mandell Gray, who describes the AHC program and the three approaches organizations can take to participate. Continue reading

AMCs, Teaching Hospitals Stand to Gain Under New CMS Model

This blog post was written by Michelle Wilkinson, Manager, and Emma Mandell Gray, Senior Manager.

Last month, the Centers for Medicare & Medicaid Services (CMS) announced a new initiative geared toward improving healthcare delivery. The Accountable Health Communities (AHC) model attempts to bridge a critical gap between clinical care and community and social services by screening Medicare and Medicaid beneficiaries for certain health-related social needs in the core areas of housing, food, utilities, interpersonal violence, and transportation. CMS’s goal is to ultimately improve overall care and health outcomes by steering patients to the appropriate community resources available to them. Continue reading