Pursuing Success in a Value-Based World

The Affordable Care Act has fended off multiple legal challenges. CMS has already implemented one mandatory bundled payment initiative and is eyeing more. MACRA looms on the horizon.

It’s an understatement to say the healthcare industry is in a period of dramatic change, and the continuing shift to value-based care will require radical thinking on the part of health system executives. But for those leaders willing to embrace change, the evolving landscape offers tremendous opportunity to remake their organizations and achieve new levels of success.

In this brief video, ECG Principal Jim Lord talks about the transition to value-based care and how forward-thinking health organizations can position themselves to thrive.

In Healthcare, Data Drives Value

Much has been written and discussed about preparing and positioning for value-based care, with efforts under way across the health system to reduce costs, expand access to care, and improve outcomes. However, attempting to meet these demands without the requisite information, analytical competencies, and a clearly defined strategy for doing so will bury an organization. Health systems cannot and should not underestimate how data, and the insight it provides, is vital to an organization’s readiness for value. I recently shared some thoughts on this topic with Alison Lake Benadada of The Washington Post for her article How Data Can Inform Value-Based Healthcare. Continue reading

When Data Becomes Strategic

We have been told that data leads to information, and information leads to knowledge. It is this knowledge, then, that drives innovation – the engine powering transformation in healthcare. While the luster of innovation is what grabs our attention, data and analytics are what make it possible in the first place. Continue reading

MACRA Forces Providers Seeking APM Track to Move Quickly

In the recent proposed rules for MACRA, CMS offered some clarity for providers who are trying to decide whether to participate under the Merit-Based Incentive Payment System (MIPS) or the Alternative Payment Model (APM) track.  In short, it really is not a decision that the provider makes, but rather a determination made by CMS based on the provider’s level of participation – if any – in qualifying APMs (also known as advanced APMs). Continue reading

MACRA Proposed Rules Provide Some Clarity, But Questions Remain

Last week CMS released its much-anticipated proposed rules for the Medicare Access and CHIP Reauthorization Act (MACRA), which was passed by Congress approximately 1 year ago and introduced substantive changes in the way Medicare will reimburse physician services. Readers of previous ECG blog posts and articles may recall that, like the ACA before it, this legislation grants the HHS Secretary great latitude in fleshing out the details through rulemaking. While these are only proposed rules, and CMS is using this as an opportunity to solicit commentary from the public, they do shed light on what we can expect when the rules are finalized in November. Continue reading