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.

LP Data Insight: Medicare Spend by Service Type and Beneficiary Age
June 14, 2016

Using CMS Limited Data Set (LDS) 2013 claims data, I examined the distribution of all Medicare fee-for-service (FFS) costs. The LDS claims file consist of 100% of all FFS claims for inpatient, outpatient, home health, skilled nursing facilities (SNF), and hospice. However, they include only a 5% sample for claims related to durable medical equipment […]

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Comprehensive Primary Care Plus (CPC+): 4 Positive Implications & 2 Practice Strategies
June 9, 2016

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, […]

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Comprehensive Primary Care Plus (CPC+): Transformational Physician Managed Care
June 6, 2016

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.

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Defining High-Value Behavioral Health Providers for ACO Partnerships
May 16, 2016

This brief offers recommendations for evaluating behavioral health providers. ACOs assessing these providers should be less selective.

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Defining High-Value Post-Acute Care Providers for ACO Partnerships
May 16, 2016

This brief describes the characteristics of high-value post-acute care providers, an industry segment that is becoming increasingly important to ACOs.

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Defining High-Value Pharmacists for ACO Partnerships
May 16, 2016

This brief discusses the characteristics of high-value pharmacy providers. Opportunities for retail and clinical pharmacists for ACOs.

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Defining High-Value Specialists for ACO Partnerships
May 16, 2016

This brief includes guidance for evaluating specialist partners.

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Defining High-Value Hospitals for ACO Partnerships
May 16, 2016

This brief describes the characteristics of high-value hospitals, a crucial partner in accountable care, and one that requires careful qualitative assessment.

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