Reference-based Pricing Gets Put to the Test in Virginia

Make no assumptions about reference-based pricing! Not yet, anyway… Reference-based pricing in healthcare is an interesting concept. What it is and how it works: Reference-based pricing is a relatively new healthcare reimbursement model where employers contract with a company to negotiate payment rates outside a traditional HMO or PPO contractual relationship and...

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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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The 340B reductions

So… 340B changes making you nervous? Pull up a chair and pour a cup of tea or coffee. Let's talk about it. As you may have heard, new 340B guidelines announced in November 1, 2017 and became effective January 1, 2018.  Since the announcement I’ve been working with hospitals on strategies to implement,...

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