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 “Exit Polls”: Initial Thoughts on PTAC’s First Meeting
May 11, 2017

Background The Centers for Medicare and Medicaid Services (CMS) has initiated a process whereby physicians and other stakeholder entities can design physician-focused payment models (PFPMs) that fit with their clinical practices, while also providing better outcomes for patients, and recommend such models to the Health and Human Services Secretary (the Secretary) for consideration and/or further […]

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The MACRA All-Payer Advanced APM Pathway: System-Wide Implications
May 3, 2017

Background The Quality Payment Program (QPP) under MACRA is now more than three months underway into the first payment year. However, there are still many nuances of the program, specifically under the multi-payer Advanced APM option, that payers —including commercial, Medicare Advantage, and Medicaid — and clinicians need to understand before they can begin collaborating, […]

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Post-Acute Care (PAC) Optimization in a Value-Based Economy: Bridging the Gap Between Hospital and Home
May 2, 2017

Post-acute care (PAC) covers a range of health care services after hospitalization, including Long-Term Acute-Care (LTAC) hospitals, Inpatient Rehabilitation Facilities (IRFs), Skilled Nursing Facilities (SNFs), and Home Health (HH) agencies. Historically, health systems had little reason to closely integrate with PAC providers or even examine PAC providers on measures of cost and quality, largely because […]

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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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