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3 Payer-Driven Strategies to Transform Care Models

Health Leaders Media

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  February 10, 2016 Follow us on FacebookFollow us on TwitterJoin us on LinkedInRSS feed

3 Payer-Driven Strategies to Transform Care Models

Rene Letourneau, Senior Editor for HealthLeaders Media

Spectrum Health, a not-for-profit, integrated, managed care healthcare organization, is focused on redesigning care models to increase value. Its insurance arm has been key. >>>


Editor’s Picks

CVS Health Posts Strong Retail, Omnicare Outlook

CEO Larry Merlo is upbeat about the growth potential for walk-in clinics and as a consequence of its acquisition of OmniCare last summer, sees "opportunities across the spectrum in skilled nursing, assisted living, and the independent living spaces." >>>

How CMS Aims to Boost MSSP Participation

By proposing changes to performance benchmarking, Medicare officials are trying to improve the odds that cost-effective healthcare providers will earn spending-benchmark-beating payments in the Medicare Shared Savings Program. >>>

As Pension Plan Red Ink Flows, A Health System Reacts

Defined benefit plans at health systems all over the country are floundering under the combined weight of rising premiums, low interest rates, and an updated lifespan forecast from the Society of Actuaries. >>>

Unwise Medical Choices Stubbornly Defy Eradication

Studies suggest both physicians and patients are reluctant to give up low-value healthcare services that waste money and can do more harm than good. >>>

Medical Boards Fail to Punish Docs Who Commit Sexual Misconduct

An analysis of data from the National Practitioner Data Bank shows that 70% of physicians sanctioned for sexual misconduct by a hospital or other healthcare organization were not disciplined by state medical boards for their behavior. >>>

A Payer and a Partner Make the Case for Extensivists

Advocates for the extensivist model say it doesn’t replace primary care, but provides additional oversight and resources needed to prevent gaps in care. Older, sicker patients in particular, have been shown to benefit. >>>

AHA Slams CMS for ‘Unlawful’ Two-Midnight Rule Pay Reduction

The American Hospital Association is highly critical of CMS’s decision to reduce IPPS payments as a result of implementing the two-midnight rule, with the organization seeking more information on the cut. >>>

Business Roundup: LifePoint Health Enters South Carolina Hospital Market

Under LifePoint’s deal finalized this month with Sisters of Charity Health System, Providence Hospitals will change its tax status to for-profit and will pay taxes, but will retain its Catholic affiliation, mission, and charity care mandates. >>>

Intelligence Report

Intelligence Report: The Outpatient Opportunity—Expanding Access, Relationships, and Revenue

In this HealthLeaders Media research report, the reasons behind ambulatory and outpatient care expansion may originate from different strategic points of view, but the tactics and objectives have much in common.
Order Today >>>

News Headlines

Healthcare ‘homes’ save MN $ 1 billion

Star Tribune, February 10, 2016

Virginia hospital group bankrolls ominous-sounding TV ads against regulatory bill

The Washington Post, February 10, 2016

Cigna and Novartis set heart-drug price based on health outcome

Reuters, February 10, 2016

White House seeks $ 1.8 billion for Zika virus response

NBC News, February 9, 2016

Bill would require identifying struggling VA hospitals

The Tennessean, February 9, 2016

Opinion: Hospitals can succeed with episode-based bundled payments

U.S. News & World Report, February 9, 2016

Why it took years for the FDA to warn about infections tied to medical scopes

Los Angeles Times, February 8, 2016

The 20 best jobs in healthcare

Business Insider, February 8, 2016

The big problem with high healthcare deductibles

The New York Times, February 8, 2016

Companies form alliance to target healthcare costs

The Wall Street Journal, February 5, 2016

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Our award-winning Daily News & Analysis e-newsletter can keep your leadership team abreast of relevant breaking news, and with in-depth industry coverage through 10 weekly e-newsletters that hit every pillar of healthcare, we’ve got your whole leadership team covered. Subscribe to any — or all — of our e-newsletters.


Webcast: Using Embedded Case Managers to Reduce Readmissions and Streamline Care

Date: February 16, 2016, 1:00–2:00 p.m. ET
In this expert webcast, discover how organizations have improved quality and clinical outcomes through embedded case management.
Register Today >>>

From HealthLeaders Magazine

Big Ideas

What big ideas have you enacted? What big opportunities await your organization? >>>


Ups and Downs of High Volume


Remaking the Board

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