Looking Back at the Past Ten Years: Managed Care, Medical Tourism, Concierge Medicine and Bundled-priced Surgery Case Rates...
by Maria K Todd MHA PhD In the USA, according to the census data from 2016, rural areas cover 97 percent of the nation’s land area, home to 19.3 percent of the population (about 60 million people). By this, I refer to the official definitions developed by the Census Bureau which identifies two types...Continue reading
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 pay hospitals a negotiated amount based on a multiple of Medicare’s...Continue reading
Recently, I've been taking calls from venture capital investment funds and bankers curious about my impression and experience with community-based freestanding emergency departments. Most of the questions are similar: Why this, why now, what's next, hurdles and obstacles? They also want to know if I can share any proven contracting strategies with third party...Continue reading
The Affordable Care Act's high-cost plan tax (HCPT), popularly known as the “Cadillac tax,” is a 40 percent excise tax on employer plans exceeding $10,200 in premiums per year for individuals and $27,500 for families. This caused employers and labor unions who were operating self-funded health benefit plans (Employer Sponsored Insurance ("ESI")) to take note of...Continue reading