Weekly News Roundup: May 31, 2019
New and Emerging Healthcare Payer Models
Healthcare payer models are changing rapidly. This week’s roundup features new and emerging healthcare payment models: the top five financial opportunities for payers; healthcare experts weigh in on the five new CMS Primary Care payment models; why some healthcare executives are calling for Stark Law reform; and what payment looks like in social determinants of health programs.
Today’s Top Five Healthcare Payer Financial Opportunities
In this article, Bobbi Brown, Senior Vice President at Health Catalyst, uses her finance experience to identify five key areas of opportunity for finance improvement in the payer sector and provide a framework for payer CFOs to build new business models that prioritize growth, strategic recommendations, and performance management. Read More
Understanding the New CMS Primary Care Payment Models
In April, the U.S. Department of Health and Human Services (HHS) announced five new payment models for primary care, known as the CMS Primary Cares Initiative. Healthcare experts weigh in on the five new payment models. Read More
Healthcare Executives Call for Stark Law Reform
Beth Hughes’ job involves closely partnering with physicians to sync Sioux City, Iowa-based MercyOne’s operations and move the health system forward. But one regulation continues to stand in her way-the Stark law, the president of MercyOne’s Western Iowa region said.
Assessing Payment in Social Determinants of Health Programs
Despite the competing concerns within the healthcare industry, stakeholders have come to nearly one single conclusion: that the social determinants of health (SDOH) are key factors in patient health. A patient’s social circumstances, including socioeconomic status, educational attainment, housing status, or food security, can have considerable impacts on their health outcomes. Read More
How the CMS Primary Cares Initiative Will Affect the Risk Equation
The Centers for Medicare and Medicaid recently announced two transformative payment models: Primary Care First and Direct Contracting, with each having a planned start date on January 1. These models continue CMS’s push toward broader value-based transformation and shared financial risk with providers. Five options will be available to organizations across the two new models. Read More