Models for Value-Based Reimbursement The future of national medical policy may be uncertain, but one thing that is not likely to change is the trend toward value-based contracting in health care. Value-based reimbursement is a bipartisan or “purple” issue, and ironically some of the earliest models were designed under a Republican administration. Republican zeal to…
Opioid Epidemic President Trump has formally declared the opioid epidemic a public health emergency. Drug overdose deaths are now the leading cause of injury death in the United States. [1] In 2010, opiates obtained by prescription were involved in 16,651 overdose deaths (compared with 3,036 heroin-related overdose deaths).[2] While the percentage of heroin-related deaths may have increased…
Considering the $3 trillion behemoth that is the American healthcare system, what the Medicare program paid for telehealth last year is microscopic: $28.7 million. However, that’s up 28 percent from what Medicare paid out in 2015. Total telehealth claims also rose by a third last year, to nearly 500,000 in total. Given major providers…
The efforts in the GOP-controlled Congress to repeal and replace the Affordable Care Act are currently in a state of semi-limbo. Factions in the Senate have coalesced among more conservative and more moderate Republicans. The former believe the Better Care Reconciliation Act does not go far enough and requires more funding reductions to Medicaid and…
ACHA: Under the revised American Health Care Act, states would have the right to waive the Affordable Care Act’s essential health benefits as of 2020. ACHA, round two. After weeks of negotiation between the Freedom Caucus led by Rep. Mark Meadows and Republican moderates led by Representative Tom MacArthur, the Meadows-MacArthur amendment to the…
Medicaid/Medicare; What Could Change in 2017 With Medicaid/Medicare entitlements up for grabs, Dr. Jon Burroughs explains some of the options ‘on the table’ for consideration in the near future. It’s been challenging to predict the near-term futures of the Medicaid and Medicare programs, given the dramatic shift in control of the federal government…
CMS: Centers for Medicare & Medicare Services, Navigating Innovative Models in 2017 Now that Rep. Tom Price has been confirmed for Health and Human Services (HHS) Secretary, he can halt some of the agency’s mandatory programs, such as the Comprehensive Joint Replacement (CJR) model. However, value-based models will likely remain part of the national strategy…
Dr. Jonathan Burroughs explains why he does not believe that the Affordable Care Act will be repealed in its entirety by the GOP.
As a result of the Patient Protection and Affordable Care Act, there are now hundreds of Accountable Care Organizations (ACOs) throughout the United States, most of whom (93%) never realize any shared savings for its participants. Why do some ACOs succeed whereas many break-even or fail? Dr. Jon Burroughs summarizes some of the key determinants…
Given that labor is the highest variable hospital cost, precise staffing levels continue to underpin an organization’s operational efficiency. Salaries and benefit dollars typically account for well over 50% of total operating costs in most hospitals and health systems.