Primary care physicians get the carrot when CMS incentivizes reduced readmissions and population health, while hospitals get the stick for the same goals. Nevertheless, hospitals and health systems should benefit from physicians joining the effort.
Health plans face challenges such as an influx of people into Medicare and more pressure to participate in risk-based contracts. The uncertainty that complicated health plan strategies in 2017 will continue this year and could accelerate.
A provision in the tax bill that passed on Wednesday means that more Americans will be hit sooner with the Affordable Care Act's "Cadillac tax" on high-quality health plans. Consumer groups are urging Congress to repeal the tax.
Healthcare financial leaders often lack a true understanding of the cost of care across service lines or populations. Focusing too much on clinical data from the medical record can lead to overlooking critical claims and demographic data.