http://www.healthleadersmedia.com/leadership/healthcare-changes-so-must-its-ceos-cfos-coos%E2%80%A6
Tag Archives: Health System
How Health Systems are Right-Sizing Their Boards
Prudent healthcare executives and boards are busily rethinking the size, composition, and focus of their governing bodies.
“An increasing number of boards are asking the question: ‘Are we structured in competency, number, and culture to lead a nine- or 10-figure business going forward?’ The time it takes to recalibrate can be fairly significant.”
“You’ve got to get beyond shared governance after a while and move toward unified governance. The right time is when you have a sense the board is struggling to keep up with the agenda and provide oversight.”
The Promise and Pitfalls of Bundled Payments
Why Bundled Payments?
Under bundled payments, a single payment is made for all of the services associated with an episode of care, such as a hip or knee replacement or cardiac surgery. Services might include all inpatient, outpatient, and rehabilitation care associated with the procedure.
There are a number of potential advantages to this payment approach. Bundled payments give providers strong incentives to keep their costs down, including by preventing avoidable complications. Bundled payments also can encourage collaboration across diverse providers and institutions, as well as the development and implementation of care pathways that follow evidence-based guidelines. In addition, bundles target the work of specialists, who have been less likely up to now than primary care physicians to participate in value-based payment arrangements.
More conceptually, health care economists are drawn to bundled payments because a bundle of care constitutes a clinically and intuitively meaningful “product” — in this case, the clinical episode. Defining clear products in health care helps create markets in which providers directly compete on quality and price. One barrier to effective health care markets has been that prices, when available, tend to relate to inputs into clinical care — such as pills, bandages, bed days, or X-rays — that are not meaningful to consumers of care and that don’t necessarily predict the total costs of care. For example, a health system that charges a lot for X-rays may still be more efficient because it uses fewer of them or saves money on other inputs. Bundles bring all these inputs together into a single price for a single basket of services.
Without Medicaid expansion, Texas hospitals left holding the bag
http://www.fiercehealthcare.com/finance/without-medicaid-expansion-texas-hospitals-left-holding-bag
Should Texas ever decide to expand Medicaid eligibility under the Affordable Care Act, its hospitals would be spared about $358 million a year in costs tied to uncompensated care, a new study has found.
The research was conducted by the Florida-based consulting firm Health Management Associates on behalf of the Texas Health and Human Services Commission, The Dallas Morning News has reported. The report was not immediately available online.
If Medicaid were expanded, about 9 percent of the approximately $4 billion a year Texas’ hospitals spend on uncompensated care could be saved, the newspaper reported. Health Management Associates (HMA) predicted about 668,000 Texans out of the 1.1 million eligible for Medicaid coverage would enroll if eligibility were expanded.
But, quoting the report, the newspaper said that Texas lawmakers are not inclined to expand Medicaid anytime soon.
Micro-hospitals could prove financial boon and salvation to healthcare systems
So-called “micro-hospitals”–acute care facilities with six to 10 beds–could actually prove to be big moneymakers for healthcare systems.
The Indianapolis Business Journal has reported that such hospitals can allow healthcare systems to bypass site neutrality rules that prohibit billing at inpatient rates if a facility is located more than 250 feet from an acute care facilty. Moreover, their construction costs, at between $7 million and $30 million, are a fraction of what it costs to build a full-size hospital.
Most micro-hospitals are open around the clock like a typical acute care facility, but they tend to offer limited services, such as observation care and short stay inpatient admissions.
A “Volatile Marketplace”: Second Quarter Earnings Calls Offer Glimpse of How Insurers Are Faring on ACA Marketplaces—and What 2017 Might Bring
This has been a turbulent year for the Affordable Care Act (ACA) marketplaces. As part of our ongoing efforts to better understand how the post-ACA insurance markets are evolving, we reviewed the 2016 second-quarter (Q2) earnings calls and financial filings of several large, publicly traded insurers that participate on the marketplaces: Aetna, Anthem, Centene, Cigna, Humana, Molina, and United.1 While the picture provided by these calls and financial reports is limited – dozens of other participating insurers are not required to report to investors because of their nonprofit or private status – they can help us better understand some of the trends affecting the marketplaces’ stability, including insurer exits from some health insurance marketplaces and increases in 2017 premiums.
Kaiser CEO Bernard Tyson on Balancing Technology and Human Touch
http://www.medscape.com/viewarticle/867711#vp_1
In this One-on-One with Medscape Editor-in-Chief Eric Topol, Bernard Tyson outlines his remarkable career at Kaiser Permanente, where he advanced from a position in the medical records department to become CEO of the $60 billion-a-year company. He also talks about why the human touch will always be at the center of healthcare, even as technology revolutionizes patient care.
Chris Van Gorder on Scripps Health’s “no lay-off” philosophy
Scripps Health CEO Chris Van Gorder talks about their “no lay-off philosophy.
Chris Van Gorder on the changing face of healthcare
Scripps Health CEO discusses the changing face of healthcare and his hope for the future.
Chris Van Gorder on 3 major themes of front-line leadership
AHL founder & CEO Dan Nielsen sat down for an in-depth interview with Chris Van Gorder, president & CEO of Scripps Health in San Diego, CA. This is a brief excerpt from that interview, during which Van Gorder describes 3 of the major themes of what he calls front-line leadership—the focus of his book, The Front-Line Leader: Building a High-Performance Organization from the Ground Up.
HENRY KOTULA 