Financial Sustainability

Financial Sustainability Report: September 2020

November 23, 2020 4:17 pm

The September 2020 Financial Sustainability Report, sponsored by Kaufman Hall, explores looming imperatives and opportunities for healthcare providers, including the Medicare Direct Contracting APM and the price transparency rule, with guidance on steps to prepare.

Medicare Direct Contracting

How to lay the foundations for success under CMS’s new MDC program 
By Allen Miller, MPH, and Shanah Tirado, MBA, MPA
The CMS Medicare Direct Contracting (MDC) program offers hospitals and health systems a unique opportunity take the next step in value-based payment and population health management. Success requires the right targeted investments in expertise and infrastructure.

Price Transparency

How to develop a winning pricing strategy
By Kevin Sears, MHA, and Chris Sukenik, MBA
Price transparency mandates imposed by the U.S. Department of Health & Human services will require providers and health plans to develop comprehensive pricing strategies tailored to their specific market positions, financials and operational objectives.

Leadership

How to build a resilient not-for-profit healthcare company
Sponsored by Kaufman Hall
By Eric Jordahl
To build a resilient organization that can withstand adverse changes to its core business model,  leaders should create a foundation for absorbing first shocks of dislocation by breaking the company into three components: an operating company, finance company and investment company.

COVID-19: Recovery and Aftermath

4 crucial health system responses to the revenue impact of COVID-19
By Timothy E. Kinney, Richard F. Bajner, Jr., and Jeff Goldsmith, PhD
To recover from the unexpected disappearance of hundreds of billions of dollars in patient care revenue caused by the COVID-19 pandemic in just a few short months, hospitals and health systems require both operating discipline and a dynamic approach to budgeting and managing payer relationships.

3 contracting strategies to accelerate a COVID-19 financial recovery for providers
By Kathy Najarian, MHA
While U.S. providers have suffered profound financial losses because of COVID-19, health insurance companies have actually benefited from the pandemic. Providers require effective strategies to achieve a more equitable balance.

Expect a surge in managed care audits and reviews in the COVID-19 aftermath 
By Greg Ford and Dawn Crump, MA, SSBB, CHC
As the hiatus in payer reviews and audits that providers experienced immediately following the outbreak of COVID-19 comes to an end, providers should prepare for a surge in audit activity and to take steps to address this issue in their managed care contract negotiations.

Commentary
U.S. stands at the forefront of efforts to develop a COVID-19 vaccine 
By Ken Perez
The development of a COVID-19 vaccine has been likened to a horse race, and a huge one at that, as there are currently more than 140 candidate vaccines at various stages of development.

Wellness

Commentary
Physician perspectives: How to access the healing power of children

By Martin H. Bluth, MD, PhD
Children have a unique power to integrate their realities in ways that we adults have long forgotten. It may be time for healthcare organizations to tap into that quality children possess to promote healing.

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