Our Latest Thinking

We are constantly scanning the health care market for new and interesting developments; then we write about them here. Check out our latest thinking.

The Future of Medicaid
May 1, 2017

The Affordable Care Act turned Medicaid into America’s largest public health care coverage program. While the volume associated with this growing program created increasing opportunities for providers, health systems, health plans, and vendors, these same stakeholders shouldn’t write off opportunities in Medicaid now simply because of the change in direction at the federal level. Instead, […]

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Bundles: Not Just for Your Cable and Internet
April 27, 2017

Bundle payment models, including the Bundled Payments for Care Improvement Initiative (BPCI), are an important part of the episode-based health care value transformation.  However, they are also under increased scrutiny, in part due to strong concerns among some Republicans regarding mandatory models as well as the idea that they do little to curb the volume […]

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Torch Insight: A Revolutionary Way to Look at Health Care Markets
April 25, 2017

Today, businesses striving to understand health care markets purchase siloed data. While data exists on individual industries (provider, payer, pharmaceutical, etc.), the data lacks the key connections needed to provide visibility into the relationships between those industries and how markets actually operate. Imagine buying individual strands of dried spaghetti from many sellers, binding them together, […]

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Six Characteristics of Successful Post-Acute Care (PAC) Value Networks
April 18, 2017

Between 2001 and 2015 Medicare payments to post-acute care (PAC) providers more than doubled.[1] As such, PAC represents a growing opportunity for value-based entities such as accountable care organizations (ACOs), bundled-payment model participants, and medical groups to create savings in overall spend. Consider that five percent of Medicare beneficiaries account for almost 50 percent of […]

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Overview, Impact & Strategic Considerations of the Quality Payment Program
March 31, 2017

In April 2015, Congress enacted a law that alters the method by which physicians and other health care providers are paid for Medicare Part B services.

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Cancer Treatment Costs are Consistently Lower in the Community Setting Versus the Hospital Outpatient Department
March 30, 2017

Nearly 1.7 million new cancer diagnoses in the United States are projected for 2017. Controlling the cost of treating cancer is an important consideration for curbing the overall cost of health care.

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A New Approach to Help Advance Health IT Interoperability
March 24, 2017

Interoperability within health care has long been a goal within the health care IT ecosystem. Historically, interoperability has been focused on providers exchanging data with other providers under HIPAA. Although advances have been made, true data liquidity between providers, consumers, and caregivers has yet to be achieved. It is essential to find better ways to […]

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Charlie Brown, Lucy, and Risk Corridor Payments
February 17, 2017

On October 13, 2015, your humble blogger received the AIS Inside Health Insurance Exchange quote of the day related to non-payment of the Risk Corridor payments, “…. there was a contract going into this that there would be certain protections… and plans would price as best as they could, knowing that there was no actuarial precedent for the risk. The news that CMS could pay carriers 12 cents for every dollar requested for the first year of the risk corridor program felt like Lucy moving the football at the last second.”

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