ACOsCMS RulesCorporate Health CareEpisodes of CareFuture of Health CareValue-Based Health Care
December 13, 2022

5 Key Health Care Trends to Watch for in 2023

After an intense few years in health care, will 2023 deliver more punches? While 2022 was dubbed a COVID “recovery” year, as patient volume rebounded, health care staffing shortages festered. Burnout prompted physicians to retire, sell practices to corporate owners, or leave traditional health care for other employment. Simply put, 2022 was short on recovery and stability. Even still, 2022 fostered important new trends and discoveries. Despite inflation and recession fears, corporate health care continued its growth undaunted, with new startups and equity-backed practice expansion. Value-Based Care spurred corporate territorial reach into legacy health care preserves. Optum, ACO enablers like…
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ACOsCMS RulesFuture of Health CareMIPS Value Pathways
November 7, 2022

2023 PFS Final Rule: 8 Key Strategies that Boost New ACOs and Increase Health Care Access

It’s here. The 2023 CMS Physician Fee Schedule Final Rule has been released, and in a mere 3,304 pages, CMS has largely finalized its proposals from over the summer. To save you from pouring through all the minutiae, here’s what you need to know. Overall, in this Final Rule, CMS has codified principles to fulfill the goals outlined in the Innovation Center’s Strategic Refresh of October 2021. Most notably, CMS has committed to having all Traditional Medicare beneficiaries in an accountable care program by 2030, and to prioritize health equity. To make this happen, CMS needs to shake up the…
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Alternative Payment Models (APM)APM Performance PathwayConsumers & PatientsFuture of Health CareValue-Based Health Care
October 26, 2022

Need to Fire Up Your APM’s Consumer Strategies? Start Here

You've read it and you've experienced it: consumer frustration with an impersonal health care bureaucracy offering few conveniences, difficult navigation, high cost, and lack of transparency. Even as some organizations try to move forward with consumer-focused strategies, these are often still fledgling efforts with little overarching structure that fail to attract consumer attention. Beyond implementing an EMR patient portal, traditional providers have been slow to develop the consumer focus necessary to generate trust and loyalty. Meanwhile, consumers are welcoming an abundance of health apps and other resources that enable them to manage their health and, if sickness strikes, get quick…
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ACOsAlternative Payment Models (APM)Future of Health CareValue-Based Health Care
October 5, 2022

Eight Key Strategies for APM Contracting Right Now

Are you considering entering into APM contracts with private payers? Bravo! Teaming with commercial health plans and employers is a strong opportunity for growing patients through APM arrangements. Expanding your APM agreements into all payment types will be essential to back the incentives you build into your workforce for performance-based pay. But those contracts must align with your APM strategies and support your goals. Our focus here is on APM contracts with health plans. Health plans may be eager to adopt these arrangements with you, if their analytics of your organization demonstrate good outcomes and reasonable costs. Population-based payments, which…
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ACOsFuture of Health CareRiskValue-Based Health Care
September 28, 2022

Just in Time for New Challenges: Updated “Supercharge Your ACO”

Our most popular eBook, Supercharge Your ACO for Top Value: A New ACO Strategy Playbook, just got better with new updates. Reflecting changes in the ACO model and environment over the year since publication, Roji Health Intelligence’s free eBook supports your journey to successful participation in Value-Based Care with the latest information and guidance. Here’s why that matters: The Accountable Care Organization model is dramatically changing. Just consider that the latest model with population-based payments, ACO Reach, is on the threshold to replace CMS's Direct Contracting and Next Generation APMs. This allows more risk-ready providers to adopt the ACO Reach…
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Smart Guide for APM Success, Terry Hush, Roji Health Intelligence
Alternative Payment Models (APM)Future of Health CareRiskValue-Based Health Care
August 11, 2022

Your Smart Guide for APM Success

In the next several years, one of two things will happen: Either traditional health care providers will make the largest, make-or-break transformation of health care system economics and delivery of care in U.S. history, or the legacy health care system as we know it will not survive, but will be absorbed into the new corporate business of health care. Successful APM adoption will make the difference. What is driving this transformation? Three forces are responsible: First, the urgent cost crisis in health care demands that providers become more accountable for costs and better patient care, and adopt value-based payment models…
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three-decisions-apm-adoption
ACOsAlternative Payment Models (APM)Future of Health CareNew Script for APMs
July 13, 2022

Three Key Decisions to Direct Your APM Adoption Strategy

How you ramp-up to full-scale APMs is crucial. Even if your multi-specialty group or health system receives some value-based payments with downside risk, your success hinges both on financial viability and retention of your clinicians and patients. If you delay APM adoption only after reviewing the potential on your bottom line, you’ll need to pay more attention to the competition that is lapping at your foundations of your provider network and consumers. Here are three key organizational decisions that will determine how your APM adoption proceeds: Should we own, enter into a joint venture, or participate in APM(s)? How much…
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5-imperatives-for-value-based-care-technology
Alternative Payment Models (APM)Episodes of CareFuture of Health CareNew Script for APMsPerson-centered Health CareValue-Based Health Care
June 23, 2022

5 Imperatives for Your Value-Based Technology to Support APMs

After years spent transforming your health care technology, you may feel like you're almost done. But Value-Based Care Technology requires a different mindset. With reimbursement scaling to a tipping point for APM adoption, think "reboot" instead. Your health system or group has a long way to go if your aggregated and integrated data cannot support person-centric care and data-directed population health, quality, and health equity strategies. The Value-Based Care Technology game is no longer focused on implementing an EHR, or even population health. Those are basic ingredients that make it possible to do more. Now it's about bringing all the…
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Alternative Payment Models (APM)Consumers & PatientsFuture of Health CareNew Script for APMsValue-Based Health Care
June 8, 2022

Six Ways Competition Must Shape Your APM Strategy

Now that you've made the decision to start your path to Alternative Payment Models (APMs), what's the first thing you need to consider? Hint: APM revenue calculation does not top the list. Obviously, APM revenue generation vis-à-vis traditional Fee-for-Service is critical. But those calculations assume constancy of two essential “assets”—clinicians and patients. Your competition is working hard to grow these same resources for their own operations. The easiest place to get them from is your organization. If you are following the growth of practice acquisitions from investor-backed health care companies and MSOs, payer practice acquisitions and retail giant investments in…
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Alternative Payment Models (APM)Future of Health CareValue-Based Health Care
May 18, 2022

Wanted: Better Script for Health System and Medical Group Transition to APMs

Health care has been suffering for a while—just ask any participant, including patients. You will hear about burnout, pressures to perform, changes in the market, pressures of new technology, fiefdoms, consumerism, and to top it off, the buildup of competition between traditional health care enterprises and new corporate health care businesses. Then there’s the pandemic, which may be sidelined publicly but continues to ravage health and the business of health care. Value-Based Care and its sidekick, Alternative Payment Models (APMs), continue to pressure health care finances. Providers, who have played cat-and-mouse with APMs for a while now, are beginning to…
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