Why America’s Rural Hospitals Suffer under Shared Risk and Full-Risk Payer Contracts

In managed care agreements, payers regard rural and urban hospitals as “hospitals”, all uniform in character. But in reality, huge variations in the demography, economics, culture, and environmental characteristics of different rural places make them very different from their urban counterparts and distinctly different from their other rural competitors. Large rural and suburban bedroom...

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Managing Managed Care Contract Renewals

Why is the process of renewing and renegotiating #managedcare #contracts still such a challenge for providers? Are they not utilizing the tools properly? Are they not adding the contracts into their systems properly? Do the tools have some necessary features missing? Is there some other reason?...

Data Blocking and its Effect on Physician Integration and Alignment

CMS Administrator Seema Verma has warned that data blocking will not be tolerated. Healthcare data can be exchanged, but software and applications providers have been accused of hoarding it because for many, their business model has been designed on deriving profits from data hoarding. But if Seema Verma’s admonitions are any indication, them days...

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Vertical Integration Returns to U.S. Healthcare: What You Need to Know Now

In the 1990s, during the Clinton Administration, the USA saw many attempts to achieve vertical integration in healthcare.  Here we are again! New acronyms were initiated and made popular to describe Independent Practice Associations (IPAs), Physician Hospital Organizations (PHOs), which were managed and administered by entities known as Management Services Organizations (MSOs). Physicians felt the...

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