Tag Archives: Strategy

The #1 thing you need to know from the 2017 JP Morgan Healthcare Conference: Follow the money

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , • Leave a comment

http://www.beckershospitalreview.com/hospital-management-administration/the-1-thing-you-need-to-know-from-the-2017-jp-morgan-healthcare-conference-follow-the-money.html

Image result for follow the money

If you want to understand the future of the $3 trillion U.S. healthcare industry, the lesson of the past is to ‘follow the money.’ And no one would argue that the place to do that is the infamous JP Morgan Healthcare Conference taking place this week in San Francisco.

While there are an estimated 4,000 people attending the conference, there’s roughly another 20,000 here for ‘off the grid’ meetings in every nook and cranny you can find. It is a surreal atmosphere in the form of the top executives from more than 450 private and public companies in biotech, pharmaceutical, medical device and technology, as well as healthcare providers, payers, private equity and venture capital firms and investment banks. Simply stated, this is where medicine’s flow happens.

With that said, roughly $1 trillion or one-third of annual U.S. healthcare spend flows through hospitals and healthcare delivery systems. So, if you want to understand what’s happening now and what will happen in the future, a good place to start is in the nonprofit healthcare provider track, where CEOs and CFOs of over 20 of our nation’s largest healthcare delivery systems presented their strategic plans in rapid fire 25-minute presentations.

Together these organizations represent over $100 billion or 10 percent of that $1 trillion spend. Incredible. The average organization presenting had over $6 billion in annual revenue, 15 hospitals, close to 30,000 employees and thousands of physicians on staff. Many of the name brands in healthcare including Downers Grove, Ill.-based Advocate Health Care, Irving, Texas-based CHRISTUS Health, Cleveland Clinic, Detroit-based Henry Ford Health System, Salt Lake City-based Intermountain Healthcare, Indianapolis-based IU Health, Oakland-based Kaiser Permanente, Cincinnati-based Mercy Health, New York-Presbyterian, Chicago-based Northwestern Medicine, Northwell Health in Great Neck, N.Y., and Robert Wood Johnson Barnabas Health based in West Orange, N.J., presented along with leading children’s hospitals such as Children’s Hospital of Philadelphia and innovative physician focused models such as Marshfield Clinic in Wisconsin and Geisinger Health System in Danville, Pa.

This provided an incredibly important snapshot of both the ground level view of what’s happening in the real world today as well as the bets being placed for the future. What follows is a high-level perspective of what was shared by these prominent provider organizations.

So, follow the money…and here’s the Top 10 Trends shaping how that money is flowing:

Getting It Right: On Building a Complex Care Network

Posted on by • Posted in Uncategorized • Tagged , , , , , • Leave a comment

http://www.healthleadersmedia.com/community-rural/getting-it-right-building-complex-care-network?spMailingID=10066722&spUserID=MTY3ODg4NTg1MzQ4S0&spJobID=1061461419&spReportId=MTA2MTQ2MTQxOQS2

Jeffrey Brenner, MD

Jeffrey Brenner, MD

The nation still lacks a strategy to provide cost-effective care for complex care patients. But one physician leader has built a NJ nonprofit that is making headway.

Catholic Health Initiatives pulls out of insurance business

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

http://www.fiercehealthcare.com/healthcare/catholic-health-initiatives-pulls-out-insurance-business?utm_medium=nl&utm_source=internal&mkt_tok=eyJpIjoiTmprM1ptSXlNVEE0WWpCaCIsInQiOiJJd24rWE1HUTl5THZuZTRuaHJMOVViMlI2MFJwcSs4Q0hyaXFlcVJHc2J5WWhucGdmVkRQem9jM1dcL2NrVitKQStmdFZSeXVvMkp1S21qNWE4bHVcLzB6akJCOVAxRzROV2JcL3ZNbFFveVI5R2owbGRHdncwemtOWUpaaG8xVHhXMyJ9

Executive looking out window

As more hospitals across the country consider launching their own health insurance plans, one big hospital operator is pulling out of the business.

Catholic Health Initiatives (CHI), a large nonprofit health system based in Colorado, no longer plans to develop a “wholly owned and nationally driven” insurance business, according to The Wall Street Journal. Instead, it’s going to sell portions of the health insurance business.

The provider, which operates 103 hospitals in 18 states, lost nearly $110 million during the last fiscal year, according to the article.

Dean Swindle, chief financial officer and president of its enterprise business lines for CHI, didn’t agree to an interview for the latest news,  but told the publication in April that “it’s tough in the health plan business. You lose money. You make mistakes. You plow forward. It takes cash.”

Why Catholic Health is bowing out of the insurance field

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

http://www.healthcaredive.com/news/why-catholic-health-is-bowing-out-of-the-insurance-field/421923/

Dive Brief:

  • Tired of steep losses, Catholic Health Initiatives is looking to sell its health plan subsidiary, Modern Healthcare reported.
  • QualChoice Health, previously known as Prominence Health, sells Medicare Advantage and commercial plans to employers in six states.
  • CHI began buying up health plans three years ago as a way to adhere to the Affordable Care Act and compete with other carriers.

Hospital Impact: Navigating rapid regulatory change in a post-ACA world

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

http://www.fiercehealthcare.com/hospitals/hospital-impact-navigating-rapid-regulatory-change-a-post-aca-world?utm_medium=nl&utm_source=internal&mkt_tok=eyJpIjoiT1RWa01EQmxZV1l6WkdGbSIsInQiOiJnVitHTEdcL0c4M1JSOENxdGk2V0Q5U0ZQc3V6TFFDdEg4Y1VUWllWbVE3aVNwU2Y3QUpZdmE5aEE3ZEVRWGMyVk14V0YyUHR5MEZvMDByck9wVmFqXC9ib3pRZnNyb0lmM05sZXl1eVZJRjhBPSJ9

Sign that says "changes ahead"

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:

Nixed Hershey-PinnacleHealth marriage could send them into arms of someone else

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

http://www.pennlive.com/news/2016/11/nixed_hershey-pinnaclehealth_m.html

PinnacleHealth System and Penn State Milton S. Hershey Medical Center said a marriage made sense for many reasons.

Not the least of which was to gain size and strength needed to fend off megasystems from outside their traditional service area. Those systems, they said, are positioning to siphon away patients needing the most advanced care, thereby eroding revenues needed to support those services in Harrisburg-area counties.

But the Federal Trade Commission opposed the merger on the grounds it would create a local hospital monopoly, and Hershey and Pinnacle subsequently called off their engagement.

 Still, experts say the forces that pulled the one-time rivals together are real and won’t go away. Those forces have triggered a wave of health system consolidation all over the country. In the Harrisburg region, they have prompted players such as Geisinger Health System, WellSpan Health and the newly-merged Lancaster General Health-University of Pennsylvania Health System to eye the territory traditionally served by Pinnacle and Hershey.

Those systems now surround Pinnacle and Hershey. At the same time, health care has entered an era where health systems are forever trying to attract more patients. That often requires expanding their footprint.

“It’s going to be hard for them to maintain what they’re doing as stand-alones,” said David Sarcone, an associate professor of business management and health studies at Dickinson College.

Stephen Foreman, an associate professor of health care administration at Robert Morris University in Pittsburgh said, “I can’t say I think their positions are all that great right now.”

 

Community hospitals: What’s your long-term game plan?

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

http://www.beckershospitalreview.com/facilities-management/community-hospitals-what-s-your-long-term-game-plan.html

Related image

The volume of hospital M&A deals has doubled over the past six years, with fewer and fewer community hospitals still going it alone. For the remaining holdouts, they are at an important juncture: Should they continue fighting for independence or join a larger system?

This heavily-debated question is at the core of many board meetings. While the answer is unique to each institution, in either scenario, the community hospital that proactively controls its own destiny — instead of losing that control to market forces — can come out ahead.

Whether the future holds independence or acquisition, here is what leadership needs to know to position their hospitals for future growth.

What does it take to stay independent?
For efficient facilities with ample cash on hand, there’s an understandable allure to remaining independent. After all, the board of directors at a community hospital is typically made up of individuals from the local area who can continue to focus exclusively on addressing the needs of the local community rather than answer to a distant corporate team.

But a lean and high-volume operation today just isn’t a strong enough indicator to choose independence for the long term. Leadership must consider broader questions that take into account a host of internal and external factors:

‘Somewhere in between’: Finding the balance between quality and the bottom line

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

http://www.beckershospitalreview.com/finance/somewhere-in-between-finding-the-balance-between-quality-and-the-bottom-line.html

Values-GeneralLeadership

As healthcare continues its shift from fee-for-service to value-based care, hospitals and health systems are working steadily to try and improve quality while reducing costs. However, striking a balance between the two can be challenging.

At the Becker’s Hospital Review 5th Annual CEO + CFO Roundtable on Nov. 8 in Chicago, healthcare experts discussed how their entities balance rewarding physicians for quality and clinical activity in what is still primarily a fee-for-service environment.

“We’re not totally in a fee-for-service environment. We’re not totally in a value-based care environment. We’re kind of somewhere in between,” said Patrice M. Weiss, MD, executive vice president and CMO of Roanoke, Va.-headquartered Carilion Clinic. “In the past, the two were felt to be mutually exclusive, but recent models of care have demonstrated that quality of care can be delivered in a low-cost model.”

While the shift from fee-for-service to value-based care is slightly slower in coming to her organization’s region, they are preparing, according to Dr. Weiss.

Carilion is a nonprofit organization with a network of hospitals, primary and specialty physician practices and other complementary services. The health system offers physicians a base salary, as well as a Tier 1 bonus and a Tier 2 bonus. The Tier 1 bonus is based on scorecard measures, which include quality metrics, patient experience metrics and operating margin.

“We have found we’ve been able to reduce the cost by using evidence-based medicine, standardization of care and appropriateness of testing and imaging,” Dr. Weiss said. “This reduced utilization has not reduced the quality of care or outcomes but has reduced the cost of care, thereby positively affecting our operating margin. So improving quality care and reducing the cost of care are not mutually exclusive.”

Physician-led, cost-reducing initiatives and physician engagement have been primary drivers in achieving reduced costs and improved quality, according to Dr. Weiss. For instance, Carilion has a significant physician-led initiative on early elective inductions or deliveries. This initiative, which was based on national guidelines, resulted in less utilization of obstetrical resources at an earlier gestational age.