News Clips
STAT (1/17) Florida hospital CEO says Medicare site-neutral payment reform ‘makes some sense’ – Researchers, lawmakers, government officials, and consumers see site-neutral payments as commonsense because the care in the two settings is identical — why should the government and patients pay more for identical care, just because the provider is linked to a hospital? John Couris sees the validity in that critique. He also happens to be the head of a major hospital system. “I think site neutrality makes some sense,” said Couris, CEO of the Florida Health Sciences Center, the nonprofit parent organization of Tampa General Hospital that posted $3.4 billion of revenue in its latest fiscal year. The federal push to equalize payments across hospital outpatient clinics and freestanding physician offices has been around for more than a decade. Policymakers have been concerned that hospitals were acquiring physician practices and converting them to hospital outpatient departments for the primary purpose of collecting additional revenue — even though basic tests and services didn’t change.
Becker's Physician Leadership (1/17) Why physicians must 'reclaim' their power in 2025 – The decline in physician autonomy may also be connected to lower satisfaction in their careers and higher rates of workplace burnout. Physicians in hospital-led settings are particularly unhappy with their employment. Physicians employed in hospital-owned practices are nearly three times more likely to report dissatisfaction than their peers in physician-owned practices, according to Bain & Co. The report also highlighted that nearly 25 percent of physicians in health system-led organizations are debating a change in employers, compared to 14 percent in physician-led practices. Despite this, hope remains for physicians who may be interested in shifting toward independent practice or seeking a higher sense of autonomy in their current practice setting.
Paragon Institute (1/15) Two Paths for Medicare’s Future: Medicare Advantage and Accountable Care Organizations – Policymakers have long sought to move traditional Medicare (TM) away from its fee-for-service financing model, which rewards volume of care over quality, relies on complex and politicized administrative pricing, and inhibits care innovations that do not fit neatly into its framework. The two main alternatives that have emerged over the years are Medicare Advantage (MA) and ACOs. MA has grown to over half of Medicare enrollment, and officials at the CMS have set the goal of having every TM beneficiary in an accountable care relationship by 2030. This brief explains each of these models and highlights their structural differences and similar policy challenges.
Heath Affairs (1/15) Medicare Accountable Care Organizations In 2023: Large Savings With Increasing Value-Based Programmatic Competition – The 2023 results largely demonstrate the MSSP’s continued overall success in generating Medicare savings. While the findings must be interpreted carefully given that benchmarks are set in advance, there are several key takeaways that can be used to inform policy. Physician-led ACOs and ACOs with higher primary care penetration are again more likely to achieve higher shared savings than hospital-led ACOs. It is increasingly important to highlight that MSSP ACOs continue to achieve shared savings for improving care of traditionally underserved populations such as safety-net patients and dual eligibles.
Medical Economics (1/7) From challenge to change: Best practices for value-based care in physician practices – Value based care remains a top priority in health care, and physician practices of all types are feeling the pressure from payers to take on more risk. Despite this national trend, many physician practices have been slow to embrace these models, in part due to concerns about the ability to win in risk-based arrangements, while also performing well in fee-for-service agreements. Adopting a value-based approach to clinical, financial and administrative operations can help physician practices thrive in both worlds. This can help streamline the transition to value-based care, while ensuring better patient outcomes and greater financial stability for providers and practices.
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