News Clips
Modern Healthcare: (4/5) – Intermountain Healthcare and SCL Health have officially joined forces. The estimated $14 billion combined organization operates 33 hospitals, 385 clinics and a 1-million-member health plan staffed by around 59,000 employees across seven states. The Colorado Attorney General's Office signed off on the merger last week.
Fierce Healthcare: (4/5) – Optum has picked up Kelsey-Seybold Clinic, a large, multi-specialty group practice based in Houston, Texas. The organization partners with payers to offer value-based commercial health plans and also owns its own Medicare Advantage plan for seniors, KelseyCare Advantage. The deal, if it closes, represents a major investment in value-based care by adding a large, risk-bearing physician organization to its network.
Healthcare Dive: (4/4) – Despite concerns about widespread provider burnout as the pandemic stretches into its third year, a new study found no evidence that burnout negatively impacts the quality of patient care. Counterintuitively, physicians who report burnout could be contributing to slightly better outcomes instead. The study, which tied data from more than 1,000 family physicians to Medicare claims, found no statistically significant relationship between seven categories of self-reported burnout and measures of ambulatory care, ER visits, readmissions or costs.
Modern Healthcare: (4/4) – Regional healthcare markets across the country have experienced significant divergence in commercial-to-Medicare price ratios between 2012 and 2019, causing insurers to pay wildly different rates to hospital systems. In areas like Chico, California and Tacoma, Washington, private payers saw hospital price ratios increase by over 100 percentage points. On the other end of the spectrum, Gulfport, Mississippi had a decrease of 109 percentage points.
Health Affairs: (4/4) – Value-based payment models are a prominent strategy in health reform. Although Medicare payment models have been extensively evaluated, much less is known about value-based payment models in the commercial insurance sector. The authors performed the first systematic review of the quality, spending, and utilization effects of commercial models, extracting results from fifty-nine studies. More studies had positive results for quality outcomes (81 percent of studies) than for spending (56 percent) and utilization (58 percent).
Modern Healthcare: (3/31) – In a new episode of Modern Healthcare’s Beyond the Byline, Modern Healthcare Senior Hospital Operations Reporter Alex Kacik and Rules and Regulations Reporter Maya Goldman talk about how health equity is a cornerstone of new rural payment models.
Healthcare Dive: (3/31) – In response to a request for public feedback from antitrust regulators, the American Hospital Association said merger guidelines used to detect and analyze unlawful mergers "do not need major revisions. AHA advised against changing the guidelines "too often or too dramatically," saying adding rapid changes would be destabilizing as hospitals and health systems evaluate ongoing mergers that can take a year to iron out.
Healthcare Finance News: (3/31) – The FTC and DOJ have solicited suggestions about modernizing the guidelines in ways that better detect and prevent anti-competitive deals. In a March 30 letter to the agencies, the American Hospital Association floated two proposed revisions: that antitrust enforcers should address defects in the economic models used to evaluate hospital transactions, and that guidelines should enable antitrust agencies to account for the better care coordination that can be achieved through mergers.
Healthcare Dive: (3/31) – Healthcare workforce shortages today are unprecedented. Projections from the Bureau of Labor Statistics estimate U.S. healthcare organizations will have to fill almost 200,000 open nursing positions every year until 2030, with many of those slots resulting from the need to replace nurses who leave for different occupations or retire.
Healthcare Dive: (3/30) – To compensate for oscillating revenue from COVID-19, some hospitals have shifted their focus to outpatient service lines and alternative revenue sources, including investments. In fact, more hospitals — especially large nonprofit systems with substantial cash pools — are acting more like venture capitalists as they ramp up investments in companies with products they can use and scale.
Fierce Healthcare: (3/30) – Caravan Health, part of Signify Health, is eliminating service fees and startup costs to join its accountable care organization building program, it announced last week. The effort is part of what it calls a new “success-based” pricing model for 2022. By eliminating these costs, which can be prohibitive, Caravan Health hopes providers can provide better care and capture a portion of shared savings earned, company executives said in a press release.
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