CMS introduced Diagnosis-Related Groups (DRGs) in the early 1980s with the promise of bending the proverbial healthcare cost curve. It was the start of a prospective payment system aimed at ending the ‘usual and customary’ retrospective reimbursement system. Under this new model hospitals were paid a flat rate for treating…
According to our fourth-annual State of Population Health Survey, progress toward such accountability has stalled. In large part, this is because progress requires providers to choose to put some portion of their revenues at risk, based on their ability to manage cost and quality. Years of pilot programs by the Department…
Healthcare consolidation took a new turn this year, and in a big way. On top of deals by Anthem and Optum to acquire delivery operations, the formation of the Amazon, Berkshire Hathaway, and JP Morgan (ABJ) healthcare partnership has raised anxiety to unprecedented levels. Margin compression was already a fact…
It’s not as user-friendly as Consumer Reports, but the Centers for Medicare & Medicaid Services’ overall star rating system represents progress in getting data into the hands of health care consumers. And despite some methodological shortcomings, it puts providers on their toes, which is a good thing. On July 27,…
