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A central goal of the Patient Protection and Affordable Care Act is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new health insurance exchanges. Following the June 2012 Supreme Court decision, implementation of the law is moving forward, but states can decide whether to adopt the Medicaid expansion. As major players in the nation’s healthcare system, hospitals and health systems have a large stake in the opportunities presented and outcome of these efforts. In this article, Barbara Lyons and Robin Rudowitz describe three key considerations for healthcare executives. More Info
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As healthcare leaders deal with the many transitions related to healthcare reform, one of the open-ended questions that remains is how health insurance exchanges will work, how many patients will participate in the exchanges, and strategic and financial implications for hospitals and health systems related to public and private exchanges. This Webinar provides a strategic overview and tactical framework to prepare your organization for healthcare marketplaces (exchanges). More Info
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Hospital and health system leaders need to consider if they want to get in the population health business and how they are going to contract their traditional business with payers in a population health marketplace. This white paper provides insights and facts to help organizations make these decisions, and addresses how to balance the contradicting strategies of building the bridge to value while at the same time maximizing contract and partnering opportunities in FFS service lines. More Info
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As part of the healthcare reform law, on January 31, 2013, CMS announced that nearly 500 healthcare organizations will participate in the Bundled Payments for Care Improvement initiative beginning in spring 2013. With the passage of the Affordable Care Act, new payment methods such as bundled payment enable CMS to move away from traditional fee-for-service. Rapidly following CMS’ lead, commercial payers are demonstrating heightened interest in bundling payments to providers in an effort to rein in costs, particularly in the areas of post-acute care and avoid-able readmissions. This article looks at what hospitals and post-acute providers are bundling and offers key considerations for board members and senior executives. More Info
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Many healthcare stakeholders have expressed a commitment to pursuing value-based payment methodologies in the years ahead. Now board members and other healthcare leaders are seeking a path forward that does not pose undue risks to their organizations’ abilities to continue fulfilling their missions. The demand for value in healthcare is leading many hospitals to consider venturing into an area they know little about—population health management, which entails accepting financial risk for the health of a specific population, as health insurance companies do. Before considering taking on any significant amount of insurance risk, a board should assess whether or not it has the capabilities needed to manage this risk.
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In the months and years ahead, many healthcare organizations will be reassessing the role of physicians in the boardroom in light of dramatic changes taking place. This Elements of Governance® explores the benefits of having physicians on the board, considerations for choosing which physicians will be best as board members, possible barriers, and alternatives to increasing physician board membership.
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Executive compensation is unquestionably one of the most challenging and controversial topics on the board’s agenda. Over the past several decades, executive reward packages have become extensive and in some cases excessive, calling into question the ethics and morality of highly paid executives. As directors evaluate the compensation program for an executive or group of executives, it is imperative they ask the question, “Is the total compensation package morally or ethically correct?” More Info
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The Securities and Exchange Commission recently adopted a final rule to implement a section of the Dodd-Frank Wall Street Reform and Consumer Protection Act to address potential conflicts of interest for individuals involved in establishing executive compensation arrangements at publicly held companies, including the independence of advisors to the compensation committee. Although the rule does not apply to non-profit healthcare and was not written with this sector in mind, it provides helpful guideposts for such organizations given the potential for governance-related “spillover” from the public company sector. Timothy Cotter looks at factors to consider and action steps to take when assessing compensation advisor independence. More Info
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As both academic and community hospitals and health systems continue to develop more and more sophisticated research and development programs, boards of directors and hospital leaders are confronted with the issue of how to best ensure that the results of research and development activities are commercialized so that they can reach patients around the country and world. One of the responses was for hospitals to launch in-house venture funds, commonly called “bioaccelerator funds.” In this article, Kristian Werling explores how these funds and their investments present unique governance issues for board members and officers to consider.
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With release of its 193-page opinion on June 28, the Supreme Court announced its decision upholding the Accountable Care Act. This article looks at the ruling, as well as the strategic and financial implications for hospitals and health systems. With the Court’s ruling, there will most likely be an acceleration of reform initiatives, moving care delivery and payment from volume to value. Organizations that have started the critical work now have a green light to proceed even more rapidly. More Info
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