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Salt Lake City, UT – August 10, 2016 – Leavitt Partners and Forward Health Group have announced a collaboration to support physician groups and payers succeed in Comprehensive Primary Care Plus (CPC+), a payment initiative set forth by the Centers for Medicare and Medicaid Services (CMS). Primary care medical practices must apply for CPC+ by […]
As a former primary care clinic manager and COO of a medical group engaged in value-based contracts, I was excited to see CMS’ announcement on Comprehensive Primary Care Plus (CPC+). I welcome this shift in Medicare primary care payments away from the quagmire of Fee-For Service (FFS) and into the higher ground of partial capitation, […]
Leavitt Partners releases “Comprehensive Primary Care Plus (CPC+): Transformational Physician Managed Care,” a white paper that assesses the recently announced CPC+ initiative and its implications on various segments of the health care industry. Salt Lake City, June 7, 2016 — The “Comprehensive Primary Care Plus (CPC+): Transformational Physician Managed Care” white paper, released today, lays […]
While primary care is the foundation for effective population health management, traditional reimbursement structures under fee-for-service (FFS) do not facilitate the delivery of high-quality primary care. The April 11, 2016 announcement of the Comprehensive Primary Care Plus (CPC+) program by the Centers for Medicare and Medicaid Services (CMS) marked a sweeping move to transform the […]
Last October I wrote a blog examining the average number of days that opioids were prescribed per medicare beneficiary at the state level. There is continual interest in understanding and reducing the abuse of prescription pain medicines.1 Use of opioids to manage pain has been increasing steadily since the early 90s,2 and increased use is […]
Many experts believe that primary care can be the solution to our country’s health care woes. Primary care clinicians, in many respects, ensure our patients get the right care, in the right place, by the appropriate practitioner, in a manner agreeable to the patient. Past research on our health care system also shows that areas with […]
Salt Lake City, March 12, 2018 – Strategic provider partnerships are critical for an accountable care organization’s (ACO) economic survival and can add significant value for the consumer. In the March edition of Managed Care Leavitt Partners provides a framework for ACOs to assess individual partners and to determine the types of providers with whom […]
Salt Lake City, February 28, 2018 – Value-based care is changing how physicians practice medicine and the training they need to practice successfully. Today, Leavitt Partners published an article in the New England Journal of Medicine Catalyst, “Preparing a New Generation of Physicians for a New Kind of Health Care,” that examines how medical schools […]
Dual eligibles, individuals enrolled in both Medicare and Medicaid, are among the highest-need, highest cost patients in the United States. Although it is difficult to determine the exact number of dual eligibles, a 2012 Kaiser Family Foundation report estimates that dual eligibles comprise 21 percent of the Medicare population and 15 percent of the Medicaid […]
Where Are ACOs Headed? At this pivotal time in the accountable care movement, future ACO growth will determine whether accountable care moves from a series of exploratory programs toward mainstream adoption across the country. A significant contributor to future growth is the success of today’s ACOs and their continued involvement in the ACO model, which […]
Micro-Hospitals Defined While the health care industry continues to shift from volume to value, costs of inpatient care continue to rise, averaging $2,346 per inpatient per day. Consequently, payers and providers are seeking new ways to reduce hospital length of stay (LOS) and deliver care at less costly locations. One such mechanism is the […]
As telehealth gains traction as a way to deliver health care, Medicare reimbursement remains a major obstacle to broad implementation due in part to scoring methodology from the Congressional Budget Office (CBO). Rather than decreasing health care costs, CBO’s scoring methodology assumes that telehealth increases utilization and therefore overall costs. Recent legislation on the Hill, […]
Emergency medical services (EMS) evoke images of EMTs and paramedics responding to medical crises and transporting patients to the hospital rather than thoughts about value-based care and changes in health care delivery and payment models. EMS leaders are trying to change that paradigm through a movement dubbed “EMS 3.0.” EMS 3.0 aims to make emergency […]
The Government Accountability Office (GAO) recently issued a report outlining five key areas in which smaller, rural physician practices tend to struggle as they shift from fee-for-service reimbursement to value-based care. Given the unique nature of rural medicine, and the fact that value-based payment will continue to grow, it is important to understand these challenges […]
Medicare Advantage (MA) offers Medicare benefits through private health plans, providing an alternative to the traditional, federally-administered program. Also known as Medicare Part C, this private option traces its roots to the 1970s and received its current name and form in the Medicare Modernization Act of 2003. Since then, the number of enrollees has grown […]
On Super Tuesday, the frontrunners gained key victories in pivotal states, increasing their respective leads for the presidential party nominations. Donald Trump won across the South and in New England, while Hillary Clinton took command of the Democratic race, rolling to victories in Texas, Virginia, and across the South. The delegate count now appears to […]
Opioids are a class of drug primarily used in the treatment of pain. According to the NIH, The number of people both using and abusing opioids has increased significantly since 1999. Scientific research has revealed several deleterious effects associated with opioid prescription drug abuse. The primary concern with increased opioid prescribing is the high probability […]
On October 22, 2015, Health Intelligence Partners (HIP) convened a strategic tabletop exercise of influential stakeholders to explore and discuss current trends surrounding the ACO movement. Participants found general consensus on some fundamental assumptions and the belief statements below represent the three top conclusions from this group. However, it is important to note that there […]
One of the primary goals of the Affordable Care Act (ACA) is to provide consumers with increased access to health insurance. While both healthcare.gov (hc.gov) and state-based marketplaces (SBMs) have made significant progress towards this goal, it has been a costly endeavor with several SBMs dealing with ongoing financial and technology challenges that still persist […]
In response to a maturing community of ACOs seeking to scale and grow, Leavitt Partners’ Accountable Care Cooperative and the Brookings Institution’s ACO Learning Network are merging to form the largest accountable care collaborative in the world. The combined resources of the Leavitt Partners’ ACO Cooperative, powered by cutting edge health intelligence and primary ACO research, and the Brookings’ […]
Salt Lake City, June 18, 2015 — In response to a maturing community of ACOs seeking to scale and grow, Leavitt Partners’ Accountable Care Cooperative and the Brookings Institution’s ACO Learning Network are merging to form the largest accountable care collaborative in the world. The combined resources of the Leavitt Partners’ ACO Cooperative, powered by […]
In contrast to the 13 ACOs that very publicly left the Pioneer program, 27 participants have quietly disappeared from the Medicare Shared Savings Program (MSSP). Research by Leavitt Partners has found that while some of these MSSP ACOs have indeed left the program, most of the “missing ACOs” are the result of mergers with other […]
Just last week, CMS announced that it would like to transition Medicare to value-based payments at a quicker pace. The government will evaluate whether patients are getting healthier through measurement, while having the goal of delivering half of all Medicare payments through value-based arrangements by 2018. While the ambition of transitioning payments towards value isn’t […]
Hospitals and physicians have become more focused on the implementation of care coordination tactics among their organizational entities.
Like Billy Beane, the Coalition has embraced unconventional wisdom and today represents one of the country’s most integrated and effective care networks
Douglas Hervey, Coordinator of ACO Research at Leavitt Partners, discusses the four critical components of successful ACOs.
Douglas Hervey is the Coordinator of ACO Research at Leavitt Partners. In this role, Mr. Hervey conducts leading-edge intelligence on the accountable care movement through national tracking and monitoring of ACOs.
It has become evident that the delivery of care is changing. Tad Morley, Vice President of Health Care Services for Leavitt Partners, explains how he views the uncharted waters. The rising cost of medical care and health insurance has hit a trigger point that is shifting the behavior of health care consumers and causing the […]
The Patient Protection and Affordable Care Act (PPACA) of 2010 utilizes savings in the Medicare Advantage program to support expansion of coverage elsewhere. PPACA adjustments to the payment formula reduce Medicare Advantage benchmarks (a per-member-per-month (PMPM) rate set by CMS for each county) and rebates (a rebate from CMS if a plans bid to serve […]
I was disappointed by Congress’s vote to override the President’s veto of the Medicare bill. Congress has shown an unwillingness to change the program’s path and take on the important task of entitlement reform. I wrote more about this in the following op-ed, which ran in The Washington Times: Yesterday, the president vetoed a Medicare […]
I want to begin a series of blog entries about the promise our nation has made to provide health care to our seniors. I am going to be critical of our current course. I don’t want to see us fail. To keep this commitment requires change. Time is running out. Medicare is drifting toward disaster. […]
I thought you might be interested in a brief report on our progress related to electronic health records (EHR). They are a critical element in making the health care system become value-based. Just having electronic health records isn’t enough. The systems have to be interoperable. Interoperability means that different computer systems and devices can exchange […]
By 2030, it is estimated that the United States will lack between 40,800 and 104,900 physicians. Moreover, there is a maldistribution of physicians across and within states. To address these projected shortages, some states, depending on their current environment, could bolster their supply of physicians by increasing their existing medical school enrollment or building new medical schools. We used data from the Medicare Physician Compare database to examine state retention of their medical school graduates and how a variety of factors, such as physician age, specialty, and gender, were related to a physician’s likeliness of practicing in their medical school state. We also analyzed the relationship between state retention of physicians and number of physicians per capita. We found that on average, states retain 38 percent of their medical school graduates and physicians who pursue a non-primary care specialty are more likely to leave their medical school state. We also observed a significant negative correlation between state retention and number of physicians per capita. Additional medical schools may not sufficiently address some state’s physician shortage unless other measures are also pursued, such as increasing residency positions. As states assess their physician supply and medical school graduate retention, there is also an opportunity for states to incorporate more value-based care training into the curriculum of both their existing and new medical schools. States may also consider encouraging the use of physician and non-physician care teams as an additional strategy to addressing their primary care physician shortage.
Salt Lake City, October 11, 2017 – In the coming decades, many states are projected to have a shortage of both specialty and primary care physicians. Today, Leavitt Partners released “Majority of Physicians Do Not Practice in the State They Graduated Medical School,” a new white paper examining each state’s retention of their medical school […]
According to the National Institute on Drug Abuse and the CDC, in 2015 over 33,000 people died from opioid overdose in the United States, and in 2013 prescription opioid abuse cost the U.S. economy approximately $78.5 billion in costs related to health care, crime, and loss of productivity. Opioid abuse and the related overdose deaths […]
Dual-eligible enrollees account for a disproportionately sizeable proportion of spending in both Medicare and Medicaid programs. However, until recently, these nearly 11.5 million[i] enrollees have not been in the spotlight in discussions regarding the move toward value-based payments.
New research offers recommendations to ACO leaders seeking partnerships with various types of providers. Salt Lake City, October 11, 2016 – Today, Leavitt Partners released a series of briefs describing the characteristics of high-value providers for accountable care organization (ACO) partnerships. Each brief offers provider-specific assessment considerations, as well as a table of high-value characteristics […]
On September 7, Health Affairs published a DataWatch paper entitled “Physician Consolidation: Rapid Movement From Small To Large Group Practices, 2013–15,” which observes the difference in consolidation patterns between specialists and primary care physicians, as well as between states. Leavitt Partners used data from Medicare Physician Compare to longitudinally examine the change in the proportion […]
A blog, co-authored by Governor Leavitt, was published in The Hill. The piece, entitled “Medicare’s bundled payment proposal: progress on health care payment reform,” examines CMS’ recently-proposed initiative to expand the use of bundled payments for Medicare beneficiaries who are hospitalized for bypass surgery, heart attack, or hip fracture. The authors note that while the […]
Health Affairs releases “Physician Consolidation: Rapid Movement From Small To Large Group Practices, 2013–15,” a DataWatch paper authored by Leavitt Partners researchers that examines the continuing trend of physician consolidation into larger group practices. Salt Lake City, September 8, 2016 — Today, Health Affairs published a DataWatch paper entitled “Physician Consolidation: Rapid Movement From Small To Large Group Practices, 2013–15,” […]
By Melissa Porter & Shawn Matheson. On July 25, 2016, CMS announced a proposed rule to provide additional incentives for hospitals to provide higher quality care at a lower cost. The proposed rule seeks to increase coordination of care and decrease costs for heart attack and bypass surgery patients, creates a new Surgical Hip/Femur Fracture Treatment […]
Recently, I came across an article titled “Company’s HR Manager Really Pushing Infinite-Deductible Health Care Plan” published by the satirical website called The Onion. Knowing beforehand that the article would be far from truth, I still read it hoping for a good chuckle. While initially merely entertaining, the article’s premise made me think about the […]
The CMS ACO programs have been the subject of much debate and analysis among those who monitor and evaluate health care payment and delivery reform efforts. Much of the focus of this debate has been on evaluating the cost and quality metrics that have resulted from the Pioneer and MSSP models deployed by CMS. Some […]
Congress is enthusiastic about mental health reform. House and Senate members introduced three bipartisan bills this year, each with the goal to help ease access to health care for those with mental illness. The bills signal progress towards more mental health awareness. But, will these proposals actually fix fragmentation within mental health services? As we’ve […]
As technology continues its rapid advance, telemedicine is becoming much more relevant as a means of expanding care delivery options. While telemedicine is limited in its scope for certain services, it continues to evolve as a key component in primary care as organizations seek to more efficiently and effectively manage the care of their patient […]
A week ago, one of our colleagues found himself ill. To him it felt to be a familiar case of the common cold or flu, for which he had been treated several times over the course of his life. With a desire to demonstrate the use of the telemedicine platform Leavitt Partners recently adopted, he […]
Known as private, nonprofit organizations, CHCs have grown up over the years, and aren’t just considered the safety-net option for care anymore.
Achieving access to services for those who need care is on the mind of all health systems around the country.
For providers to truly succeed in an age that necessitates interoperability and standardization, the following solutions can avoid unnecessary headaches.
Leavitt Partners research indicates that successful HIT adoption begins with culture, simplicity, and standardization.
How care coordination tools can improve patient satisfaction and outcomes.
When patients and physicians apply shared-decision making, quality and satisfaction go up while costs go down.
Leavitt Partners explores a number of innovative tools currently on the market that can positively affect patient behavior.
SALT LAKE CITY, (November 29, 2012) — A comprehensive and cutting-edge report co-authored by Leavitt Partners and KLAS Research shares detailed information about the structure, maturity, partnerships, practice and payment arrangements of Accountable Care Organizations (ACOs) throughout the country. The report, which represents the culmination of months of survey research and analysis, is based on a […]
Mending fragmentation and coordinating interventions will inevitably play a significant role in improving America’s health. This blog features two guest writers, Neal Mason and Brittney Park from the Michael O. Leavitt Center for Politics & Public Service at Southern Utah University. The Center for Disease Control (CDC) reports that Over 75% of the U.S. healthcare spending is […]
The PPACA bill is estimated to provide health care coverage for another 30 million U.S. citizens, substantially reducing the population of uncovered persons. This will likely increase demand for health care services, and the laws of economics indicate that when demand increases and supply remains constant, one of two things can happen. Either prices will […]
By Lauren Kelley. As the House prepares to vote on the Continuing Resolution for the FY2011 Federal budget, and as Congress reviews President Obama’s FY2012 budget proposal, I’d like to share my perspective on Community Health Centers. Currently, the House is considering a $1.3 billion reduction in Federal funding for Community Health Centers in FY2011. […]
With the passage of the Patient Protection and Affordable Care Act, the US economy and its health care system will be looking forward to a serious expansion of its charitable health care program, Medicaid. In 2014, eligibility for Medicaid will expand to include income levels of up to 133% of the federal poverty level. This […]
This morning I’m driving to a clinic outside Johannesburg which is run by Sisters of Mercy, one of our NGO partners. They are affiliated with Catholic Charities. I’ll tap out a few notes on my Blackberry as we drive and then see if I can pull them together into something coherent tonight. I spent last […]
David Muhlestein discussed how the maturity of an ACO as an alternative payment model is the primary driver for its recent growth in a RevCycleIntelligence article entitled “Accountable Care Organizations Grow, But Face New Challenges.” The article highlights (and links directly to) the “Growth Of ACOs And Alternative Payment Models In 2017” Health Affairs Blog.
An AIS article entitled “New Leavitt Report Shows MA Star Ratings Do Not Shrink Premiums” discusses the findings from the Leavitt Partners The Cost of Quality: How Star Ratings Can Influence Monthly Premiums in Medicare Advantage Plans David Muhlestein was also interviewed for the article and noted that the primary finding – higher-quality MA plans […]
A new Health Affairs article entitled “Hospitals Participating In ACOs Tend To Be Large And Urban, Allowing Access To Capital And Data” discusses the impact that involving hospitals in the operation of accountable care organizations (ACOs) can have on improving health care quality and lowering cost growth. The article, co-authored by David Muhlestein, used primary data on ACO composition and capabilities paired with hospital characteristics to examine the relationship between hospitals and ACOs in various settings.
Thousands of communities throughout the United States have been identified by the Department of Health and Human Services (HHS) as underserved. Given the designation of a health professional shortage area (HPSA), medically underserved area (MUA), or medically underserved population (MUP), the communities and their individual members struggle to address health care needs. The designations given […]
Consumer-driven insurance marketplaces need greater price transparency and better decision-support tools. Health insurance is one of a few consumer goods where understanding the price of the good will require a complex calculation based on individual attributes. Additionally, identifying the “best” product for an individual requires one to blindly forecast their expected utilization over the coming […]
As public insurance marketplaces mature and pursue long-term sustainability, their willingness to continue supporting Navigator Programs may wane – leaving the future of the health care law’s hallmark consumer assistance program in question. Section 1311(i) of the Affordable Care Act (ACA) established the Navigator Program as a mandatory function of the health insurance marketplaces. The […]
For states looking to ease in step-by-step with State-Based Marketplaces, the Supported State-Based Marketplace appears to be that practical option.
A growing concern for current and future SBMs is determining how to pay for the operational costs associated with running their marketplaces
At a crossroads, employers require innovative decision support tools and guidance that allow them to explore the best path forward for their organization.
The Leavitt Partners Center for Accountable Care Intelligence releases “Optimized Medication Use: A Growing Priority for ACOs”, a white paper on the increasing priority being given to medication use strategies within ACOs
Republished from July 15, 2010 Information technology is a funny thing. It can make sharing information in a variety of formats faster, more convenient, and more accurate. However, the success of any technological advancement is entirely dependent on the rate at which its use is adopted by the intended users. And adoption depends on a […]
Cancer is one of the most significant health care problems that our society faces, impacting millions of citizens in the United States. It is the second leading cause of death in the country. According to the American Cancer Society, there will be over 1.5 million new cancer diagnoses and over 550,000 deaths attributable to cancer […]
By Andrew Clark. Information technology is a funny thing. It can make sharing information in a variety of formats faster, more convenient, and more accurate. However, the success of any technological advancement is entirely dependent on the rate at which its use is adopted by the intended users. And adoption depends on a variety of […]
A Health Life-line from the American PeopleWritten October 17, 2008 Upon arrival inside the Baghdad Green Zone, I was given a situational overview by a group of U.S. Embassy personnel, and then proceeded to a series of meetings with the Health Minister and different groups of doctors. Those meetings were held at the al-Rasheed Hotel, […]
Written June 30, 2008 This was my third trip to Nicaragua. The place has started to be quite familiar to me, and I am beginning to develop what feels like a good relationship with many of the people there, including President Daniel Ortega and his wife Rosario. President Ortega has perspectives different than those of […]
Following on yesterday’s blog, here are some additional observations about my recent trip to Viet Nam. Observation two: While they maintain a communist structure of government, Viet Nam is obviously devoted to being part of the global market economy. As people vote with their dollars, markets are highly democratic. It seems clear they have found […]
The inauguration of a new president is a major historical milestone for any nation. Inaugurations have attributes that resemble a wedding. The steps leading up to the inaugural are similar. There has been a courting period and proposal from competing suitors, a decision, and then an engagement period or transition as we call it in […]
Tuesday in India, I concentrated on drug safety by traveling to Hyderabad, about an hour flight from Chennai. My first event was a visit to Dr. Reddy’s, a significant manufacturer of generic drugs for the American market. I’m told there are nearly 100 facilities in India producing generics. It is a major industry here and […]