http://www.beckershospitalreview.com/finance/10-hospital-bankruptcies-in-2016-decmeber13.html
From increased competition to reimbursement landscape challenges, many factors led hospitals and health systems to file for bankruptcy in 2016.
Here are 10 hospitals and health systems that have filed for bankruptcy protection since Jan. 1, beginning with the most recent.
Joint ventures are gaining steam as plans and providers look for ways to work together to provide higher-value care.
Anthem and Aurora Health, Anthem’s Vivity, Aetna’s Inova, Presbyterian Health Services in New Mexico, and now Aetna and Texas Health Resources—all of these organizations and partnerships combine the strongest skills of a payer and a provider.
These partnerships allow providers to lean on the analytical and actuarial power of the payers, while focusing on improving health outcomes.
CopelandAbout 13% of all U.S. health systems offer health plans, covering about 18 million members—or 8% of insured lives. according to a report from McKinsey & Company. Also according to the company, the number of provider-owned health plans is increasing about 6% each year.
Bill Copeland, vice chairman of Deloitte and leader of the company’s U.S. Life Sciences & Health Care industry group, says payers aren’t usually as effective as providers at working with patients, and providers don’t have the necessary capital to fully invest in high-value care. Joint ventures that marry the strengths of both parties have mutual benefit and should result in lower overall costs with better patient outcomes.
By far, the biggest change Health Partners’ Donna Zimmerman sees in terms of reimbursement in 2017 is the increased momentum behind bundled payments for orthopedic care.
Zimmerman“Hospitals need to be prepared for more of this,” says Zimmerman, who is senior vice president of government and community relations at the Bloomington, Minnesota-based nonprofit healthcare provider and payer. That’s because employers are increasingly interested in bundled payments for orthopedic and other types of procedures, and they’re often offering incentives related to bundled episodes of care in benefit plans, she says.
Offering a bundled payment option for a joint replacement, in particular, is getting more common. Even with physical therapy that lasts a few months, these are “fairly discrete episodes of care,” says Zimmerman, who adds that bundled payments are particularly attractive to employers and payers since they allow them to manage the total cost of care.
As a result, provider organizations will need to continue to focus on improving their quality scores, since this is one of the primary ways to distinguish their facilities from competing hospitals. In addition to the total cost of care, Zimmerman highlights that payers will be keeping tabs on providers’ complication rates and will adjust the prices they’re willing to pay providers for bundles of care as a result.
Here’s more on how bundled payments will evolve in 2017, and two other reimbursement changes to watch.
http://www.healthcaredive.com/news/hospital-groups-aca-repeal-may-cost-billions-jobs/431786/
Click to access impact-repeal-aca-exec-summary.pdf
Click to access impact-repeal-aca-report.pdf
Members of the Republican party have been attempting to repeal the ACA ever since the healthcare law was implemented in 2010. In the proposed ACA repeal-and-replace plans currently available, such a replacement plan may not come for up to three years, Kahn said. In addition, there still doesn’t seem to be a unified front on what that replacement would actually entail.
President-elect Donald Trump has said he would make repealing and replacing the healthcare law a top priority. However, HHS Secretary Sylvia Mathews Burrell has warned that getting rid of the ACA could potentially have dire consequences, including the estimated 22 million people that could be left without health insurance coverage. In addition, current repeal-and-delay plans could widely change the already fragile individual insurance markets.
The hospital groups sent a letter to Trump and members of Congress to urge any repeal bill include a simultaneous mechanism for replacement coverage. “We strongly believe that any repeal legislation must be accompanied by provisions that protect the coverage for those currently receiving such protection,” the letter noted. What would be “absolutely essential” to include would be to restore the Medicare and Medicaid payment cuts so that hospitals can provide the care that communities “both respect and deserve,” according to Tom Nickels, executive vice president of government relations and public policy at the American Hospital Association.
Hospitals were under the impression that they would be getting more insured patients, so they reasoned that the Medicare and Medicaid payment cuts that came with the ACA implementation were not necessarily going to have a major impact, both AHA President and CEO Richard Pollack and Kahn noted on the media call. Yet the payment cuts to hospitals that date back to 1997 with the Balanced Budget Act have caused hospitals to “cut back staff, services, education, research, investments in new technology, and modernization, and upgrading of aging facilities,” the letter stated.
The losses that would come from ACA repeals as they have been proposed “cannot be sustained and would adversely impact patients’ access to care, decimate hospitals’ and health systems’ to provide services, weaken local economies that hospitals sustain and grow and result in massive job losses,” Nickels said on the media call.
One of the Dobson reports explains why the groups support using HR 3762 as a starting point. Even though the bill, which President Obama vetoed after it passed Congress, repeals ACA provisions that expand health insurance coverage and does not offer a replacement plan, it restores all ACA reductions in hospital payments that were supposed to help to finance the additional coverage, the report states.
Throughout his campaign and in the days following the election, President-elect Donald Trump said that one of his top priorities as the commander in chief would be to repeal and replace Obamacare, a major component of the Affordable Care Act (ACA). By having a Republican president as well as the GOP holding a majority in Congress (which also support its repeal), it’s likely that this will occur, says Ashraf Shehata, MBA, advisory leader for health plans and partner of the firm’s Global Healthcare Center of Excellence, KPMG.
But how do you go about replacing Obamacare when 20 million Americans are now obtaining healthcare coverage from it?
The following hospitals and health systems announced or implemented workforce reductions each affecting 100 or more employees this year. The layoffs are listed below, in descending order of the number of positions affected.
Since the Affordable Care Act was signed into law in 2010, the environment for healthcare has changed dramatically. Now, it could change even more with the possibility of an ACA repeal. But over the past six years, I have learned a few tips on how to navigate difficult times and transitions through experience, education, and collaboration with colleagues and governmental leaders. Here’s a review of some major industry trends and how healthcare organizations can adapt:
Diagnosing why innovation hasn’t stopped healthcare productivity declines
Autonomous vehicles. Augmented reality. Artificial Intelligence.
The world is undergoing radical transformation via technological innovation. Healthcare is not immune to this trend and has lately unleashed its own wonders from CRISPR to 3D-printed prosthesis to sensor-enabled pills. We can truly transform lives in ways unimaginable even just 10 years ago.
In other ways, however, healthcare lags.
In transportation, Google’s first “driverless” Street View cars were on the road a scant few years after the DARPA Grand Challenges of the mid-2000s that paved the way for them, and Uber become a verb in the same amount of time it takes to implement a current EHR system. Furthermore, Amazon’s chatty Alexa now interacts with you in your home, having arrived just a short time after Siri became the personal assistant in your pocket.
Healthcare innovation has been incapable of gaining similar traction even with profound technological advances.
There is an unmentionable dark side of healthcare innovation.
Advances in productivity via utilization of new tools and technologies has been anemic. Healthcare is struggling to keep pace with other industries. In fact, in a recent McKinsey study, healthcare is one of only two industries (construction is the other) that has shown a productivity decline. Read that again: Despite IT spending growth increasing by over 5 percent per year over the last 10 years, we’ve actually seen the healthcare labor pool and service environment become less efficient!
Hospital and health system consolidation will continue to build, giving the delivery system a significant makeover during the next decade, according to Health Care 2020: Consolidation, a new report published by the Healthcare Financial Management Association. Over that time, healthcare organizations will be challenged to prove that the changing landscape actually improves value to consumers.
The report is the third in a series of four that comprise an environmental assessment designed to guide healthcare organizations in their strategic planning efforts over the next several years.
One major trend cited by the report is that Independent physician practices are increasingly becoming an endangered species, due principally to the healthcare industry’s accelerating transition from volume to value. Regardless of whether pending mergers are allowed to go forward, the health insurance sector should remain highly consolidated for the near future.
HFMA President and CEO Joseph J. Fifer, FHFMA, CPA, said in a statement that consolidation is a trend that’s here to stay.
Most major healthcare organizations lavished praise on Price in statements released Tuesday, but Keckley paints a much less rosy picture.
“The big losers from November 8 on, with repeal a virtual certainty, are hospitals,” Keckley said. “They end up getting the raw end of the deal on doing away with the exchanges. They end up with uncertainly about ACO and bundles they’ve been developing.”
Keckley said healthcare systems are being cautious and are taking a second look at their value-based programs.
“The CFOs are saying to CEO, it’s time to be rethinking our capital commitments, interest rates are going to go up, the cost of borrowing is going up, margins are going down,” he said. “This is not a forward view where the knowns are clear. The only thing they can count on right now is, margins are going to shrink, cost of capital is going to go up.”
HENRY KOTULA 