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 population. However, … Read more
Salt Lake City, June 27, 2017 – Today, Leavitt Partners released a new white paper, entitled “Optimizing the Value of Skilled Nursing Facilities (SNFs) In Value-Based Care: Insights for Hospitals & Health Systems.” The white paper addresses how hospitals and health systems are increasingly relying on post-acute providers to provide high value, low cost care, … Read more
Introduction 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. One of the biggest challenges in moving dual eligibles to value-based payments is solving the logistical and … Read more
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 emerging trend … Read more
On April 1, 2016, the Comprehensive Care for Joint Replacement (CJR) model program took effect, affecting roughly 800 hospitals across 67 markets. Prior to the program becoming active, Leavitt Partners published a blog post stating, “Time will tell whether hospitals and providers will succeed with quality improvements and savings generation under this new program.” One year into … Read more
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, … Read more
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, … Read more
As the health care industry moves toward population-based models of care, providers are seeking partnerships to help manage the continuum of services. In order to find success in these partnerships, there is a need to identify the characteristics of providers that will yield a high degree of value for the ACO, their patients, and community. This series … Read more
