As healthcare reimbursement moves away from a fee-for-service environment, many hospitals are considering entering into bundled contracts with insurers, physicians and/or other providers. Bundled contracts take many forms but generally pay an entity a fixed or capitated amount in return…
Integration & Physician Issues
As hospitals gear up for accountable care organizations, independent physicians are "a hot commodity," says Mary C. Reed, vice president of Gateway Health in Cleveland. Ms. Reed, who is helping a number of organizations create ACOs, says non-employed physicians, who…
For a hospital starting an accountable care organization, working with physicians is crucial to success, but it takes a great deal of time and effort to have a successful working relationship with physicians, according to Nancy J. Ham, president &…
Nancy J. Ham, president & CEO of MedVentive in Waltham, Mass., has more than 10 years experience preparing hospitals to launch ventures coordinating care with physicians and other providers. Lately much of her time is taken up with helping hospitals…
The Patient Protection and Affordable Care Act includes a provision to begin a national pilot on payment bundling, which is essentially an expansion of CMS's ongoing Acute Care Episodes Demonstration project. The pilot is scheduled to launch by Jan. 2013.…
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Mark Weiss, JD, a healthcare attorney with Advisory Law Group in Los Angeles, discusses four ways physician groups can increase their earning potential and gain leverage in negotiations with hospitals and the development of ACOs.
The Federation of American Hospitals answered 10 questions posed by the Federal Trade Commission, as the agency ponders how it will handle antitrust enforcement of accountable care organizations, according to a federation letter to the FTC, CMS and the Inspector…
University of Michigan Health System has launched a physician organization, called the Physician Organization of Michigan, with 570-physician independent practice association Physicians' Organization of Western Michigan, according to a UMHS news release.
Detroit Medical Center has launched a joint-venture physician-hospital organization, which includes more than 500 physicians, according to a Crain's Detroit Business report.
With insurers nervous about possible loosened antitrust regulations for providers and stronger enforcement against payors, the industry's trade group has hired a high-ranking attorney in the Antitrust Division of the U.S. Department of Justice to be its new general counsel,…