Penny Wheeler, President and CEO, Allina Health shares her perspective on the importance of partnerships in increasing value and understanding the consumer with Jenny Cordina, Partner, McKinsey and Company in an interview conducted in June 2017.
M&A remains an important option for health systems, but targets and strategies are shifting. While traditional economies of scale will continue to be a strong stimulus for M&A, providers will likely seek and achieve value creation much differently in the future.
Healthcare is a dynamic industry with significant opportunity, but cost concerns, uncertainty, and complexity can also make it an unnerving one. Substantial upside exists for players that can deliver value-creating solutions and thrive under uncertainty.
Benjamin Breier, President and CEO, Kindred Healthcare shares his perspective on major trends in US healthcare and the value of an integrated approach with Shubham Singhal, Senior Partner, McKinsey and Company.
Performance measurement for the Quality Payment Program (QPP) has begun. Although 2017 is a transition year, providers and payors need to start planning for the future, given the QPP’s implications for them.
Despite present uncertainties, MCO leaders can still aspire to grow—and make decisions to support that aspiration. Our research shows that the key sources of growth for Medicaid MCOs are strategic, not operational.
A new concept, organizational agility, can help healthcare companies adapt more quickly to changing customer needs, competitor responses, and regulatory guidelines—without requiring a full-scale restructuring.
Pharmaceutical companies want to be rewarded for innovation, but rising drug costs are straining payor economics. This conundrum must be solved, not for one drug at a time but across the breadth of products in the pipeline.
Increasingly, consumers are seeking services at sites of care outside of the traditional health system infrastructure. This shift has important implications for how health systems think about their asset base and scale.
The findings in this Intelligence Brief provide an introductory perspective on how the next US administration and Congressional Republicans may approach altering the ACA and related legislation. The information is based on publicly reported information released through December 8, 2016. Our Reform Center team is continuing to refresh this perspective on a real-time basis and is closely analyzing potential implications and economic impacts for each policy element under a full range of scenarios.
Two steps—increasing healthcare-sector productivity and improving healthcare-market functioning to better balance the supply of and demand for health services—would likely produce sufficient savings to lower medical cost inflation to the rate of GDP growth.
Traditional arguments for EHR implementation such as efficiency gains and meaningful-use incentives are insufficient to maximize a health system’s returns on its technology investments. However, clinically and operationally oriented sources of value can generate an additional $10,000 to $20,000 per bed in annual margin.
Consumers’ accountability for healthcare spending is increasing, and more than a thousand companies are developing new digital/mobile technologies that should allow consumers to take greater control over their healthcare choices. This combination may disrupt the industry’s migration toward larger, more integrated systems and put almost $300 billion—primarily, incumbent revenues—into play.
What states, private payors, providers, and technology companies are doing to control costs and improve outcomes for individuals with behavioral health conditions or in need of long-term services and support, including those with intellectual or developmental needs.
Although structurally simple to create, clinically integrated networks (CINs) are difficult to get right. Health systems considering establishing CINs must think through what it truly takes to create value through these entities and then make sure they have designed the CINs appropriately.
Offering a health plan can give health systems an opportunity for growth, but it is not without financial risk. To benefit from this move, health systems should use a different lens to understand both consumers and risk, know where the best growth opportunities are, rethink their payor-provider interactions, and take advantage of integrated claims and clinical data.
Analysis of the HIMSS Value Suite database suggests that investments in healthcare IT can produce value, especially in terms of improved treatment and clinical care. However, gaps remain that the industry must fill before value from healthcare IT can be fully understood and maximized.
Last year, in partnership with LeanIn.Org, we conducted the first annual comprehensive study of the state of women in corporate America. The findings reveal challenges – but also optimistic notes – for women in healthcare.
As consumers take an increasingly active role in healthcare decision making, payors and providers need an accurate understanding of how healthcare consumerism is playing out. Using data from surveys of thousands of people across the U.S., we debunk eight of the most common myths circulating in the industry.
The newer approaches to managing oncology care have been somewhat effective in controlling near-term costs, but are often cumbersome and create friction between stakeholders. A more integrated program, however, can deliver long-term benefits to both payors and providers.
Updated 2015 network data, including a comparison of networks offered on the 2014 and 2015 exchanges, insights into how networks’ pricing structures are evolving, and insurer and provider participation.
The former CEO of Kaiser Permanente describes the formative experiences that led him to champion gender diversity, and reflects on the ways that diversity benefits both leaders and organizations alike.
Survey findings shed light on how a variety of factors could affect the decisions consumers make about enrolling: eligibility for subsidies, penalties for not enrolling, satisfaction with 2014 plans, and increases in premium rates.
In the post-reform era, payors will attempt to capture savings by creating limited networks with reduced reimbursement rates. To respond, health systems need a clear understanding—market by market—of their competitive advantages and of when, if, and how to trade price for volume.
For most health systems, the one-time impact of expanded insurance coverage on utilization will be small but significant. Systems that can capture a substantial share of the increase in utilization may gain a competitive advantage.
Health systems (and health plans) that are serious about transforming themselves must harness the energy of their physicians. To do so, they must develop a true ability to engage physicians effectively.
Given today’s realities, health systems must look beyond the traditional economies of scale if they want to reap the full benefits of M&A. They must consider other economies that M&A can offer, commit themselves fully to the effort, and execute flawlessly.
Although the ACA may make revenue cycle operations more complex, it also presents an opportunity for providers to improve, excel, and differentiate. By adapting their RCM operations and acquiring new capabilities, providers could open up opportunities to win.
Operating margins at AMCs are under severe pressure, placing their tripartite mission at risk. To survive, AMCs need significant structural and cultural changes. Five steps are imperative if they are to navigate the challenges ahead.
A multiprong approach that puts physicians—and clinical care—at the heart of performance transformation efforts can help hospitals and health systems deliver more financially sustainable, patient-oriented, and physician-friendly care.
By giving nurses more control over their work environment and more opportunities for professional advancement, hospitals and health systems can reduce nurse turnover, lower costs, and improve patient care.
To address the rising cost of chronic conditions, health systems must find effective ways to get people to adopt healthier behaviors. A new person-centric approach to behavior change is likely to improve the odds of success.
Articles in this publication are designed to help payors, providers, and health systems overcome the challenges ahead and leverage integrated care effectively to deliver better patient care at a lower cost.
All signs point to a more specialized future for US hospitals. But getting from here to there won’t be easy.
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