News and Insights

Population Health and Risk-based Models

Payment Reform: A Primer for Taking on Risk

hfm Magazine

Our healthcare system today is broken in large part because of how we pay for it. Our fee-for-service legacy gives providers an incentive to deliver as many exams, tests, and treatments and fill as many beds as possible. But as we know, piling on services does not equate to high-quality…

Creating Disruptive Innovation

Numerof Brief

The outlook for private health insurance remains fraught with uncertainty.  After decades of financial success, it’s difficult for many in the industry to think about meaningfully changing the current model beyond responding to the latest reinterpretation of the Affordable Care Act (ACA). However, no business model cast in stone can…

How Payers Can Promote Accountable Care without an ACO

Numerof Brief

The Accountable Care Organization (ACO) was promoted by the Affordable Care Act as one way to address the spiraling cost increases and disappointing quality outcomes that had characterized U.S. healthcare to date.  The bill offered financial incentives to encourage adoption of the ACO format, and appears to have been successful…

7 Steps to Population Health

Becker's Hospital Review

In an effort to broaden availability of healthcare insurance coverage and to control spiraling premiums and underlying costs, Congress passed the Patient Protection and Affordable Care Act (PPACA) in 2010.  While the law’s ability to address these issues has been called into question, the legislation was ultimately an indicator of…

4 Cultural Challenges of Bundled Pricing

Becker's Hospital Review

Historically, a cardinal rule guiding decision making in hospitals was that administrators made decisions on administrative matters, but decisions impacting physicians and their practice of medicine could only be made by other physicians. However, as organizations respond to current cost and quality pressures by making pricing more transparent through bundling…

Laying the Foundation for Success in Bundled Pricing

H&HN

The ongoing upheaval around healthcare reform reflects the fact that spiraling cost increases, coupled with lagging quality outcomes and a chronic lack of transparency have gotten the attention of payers, patients, and policymakers. Healthcare delivery organizations face growing pressure to address these issues. Bundled pricing is an innovation being implemented…