As payer telehealth policies evolve from short-term approaches in response to the pandemic, to longer-term approaches designed to recognize the opportunities for post-pandemic virtual-care; stakeholders need to be up-to-speed on the current state of telehealth reimbursement and contracting, as well as preparing for the future. In this disruptive environment, stakeholders also need to explore leveraging future opportunities such as remote patient monitoring, as well as understanding the return on investment that can be realized from increasing focus on virtual care.

This session begins with understanding current telehealth billing and coding and revenue cycle considerations, and will then explore opportunities to be successful in value-based and likely future performance-based virtual care arrangements.

We believe health systems must scale to achieve a level of market indispensability characterized by an integrated provider network able to invest in data analytics, bear risk, and offer patient-friendly physical and virtual care settings. But scale doesn’t guarantee relevance. Bigger doesn’t always result in better. Only those health systems that grow while advancing performance by strategically pursuing vertical integration into asset-light delivery mechanisms, exploring new business/product expansion opportunities into nontraditional healthcare services, and ensuring a deliberate and structured approach to scale will be positioned for clinical, strategic, financial, and operational success.

Part of ECG’s series of strategic perspectives on the changing dynamics of the US healthcare system, this webinar explores the relationship between size and performance, benefits of horizontal and vertical integration, and opportunities for health systems to reposition themselves for future success.

During this webinar, participants will learn:

• The Rule of Three and how it can inform health system strategy.
• Opportunities to broaden a health system’s perspective of its potential service offerings to allow for management of an even greater portion of a community’s health and well-being.
• Benefits from transitioning a health system to a more asset-light investment philosophy and options to do so.
• Guiding principles to support enhanced system performance.

 

CMS rule requiring all hospitals to publish detailed information regarding the pricing of their services effective January 1, 2021, has been finalized. Despite strong pushback from the industry, this initiative appears to be moving forward on schedule. What’s more, the industry is unprepared—an HFMA survey found that only 12% of executives believe their organizations are ready to comply with the new requirements. This is important for regulatory compliance reasons, but also because it has implications for how consumers shop for healthcare services and how providers should position themselves in their markets. In this session, ECG’s team of experts explain the rule’s requirements and health systems can best respond.

Learning Objectives

• What the CMS transparency rules are and how they will (or will not) improve transparency
• Near-term tactics for compliance
• Longer-term impact on consumer behavior and reimbursement rates
• Creative pricing strategies and patient-friendly, value-driven payment models

 

Redundancy, duplication, and waste are pervasive in today’s healthcare delivery system, driving up both operating and capital costs. To achieve economic sustainability and market essentiality, health systems must integrate and rationalize to enhance clinical care, optimize operations, and lower costs, ultimately focusing on the improvement of every aspect of patient care operations.

Part of ECG’s series of strategic perspectives on the changing dynamics of the US healthcare system, this webinar explores four imperatives for healthcare organizations looking to advance their integration and rationalization efforts:

• Capitalize on technology innovation for business tasks.
• Eliminate unwarranted clinical variation.
• Design a platform for delivering and coordinating care across the continuum.
• Implement a capital asset plan that supports integration and rationalization.

 

 

ECG’s oncology experts share industry best practices from across the country to support the successful ramp-up of cancer program operations. This session provides practical guidance based on lessons learned from leading institutions, addressing how to position operations to meet the anticipated surge in patient volumes while also continuing to ensure the safety of patients and staff at the center. In this session, we

• Discuss how to optimize performance in a COVID-19 environment.
• Explore strategies to transition patients and staff to alternative settings, as needed.

 

Health systems and provider organizations are experiencing significant financial pressure, exacerbated by the COVID-19 pandemic, while historical market forces continue to create serious challenges. Despite reform efforts that have seen mixed results, the march toward value-based care will go on. The path forward will be arduous, as we believe the current system is too costly, complex, and fragmented to remain viable.

ECG’s We Believe series offers strategic perspectives on the changing dynamics of the US healthcare system. In this webinar, ECG principal Andy Bachrodt discusses the tenuous state and future of the US healthcare provider economic model and what executives must do to guide their organizations toward a sustainable position of financial health.

Key learning objectives for this webinar include the following:

• Review and understand the foundational challenges in the US healthcare delivery and funding model.
• Define ECG’s perspective on the evolution of value-based care and industry readiness for the move to a true population health model.
• Discuss the strategies that support the four key imperatives health systems must address:
  • Own the consumer relationship.
  • Redesign the delivery network for high performance.
  • Optimize operations and cost structure.
  • Optimize revenue structure.
• Share lessons learned from participant organizations and their path forward

 

Changes to the 2021 Medicare Physician Fee Schedule (MPFS) will have far-reaching implications for provider arrangements nationally. CMS will implement the RVU changes and corresponding conversion factor reimbursement adjustment on January 1, 2021. The E&M code WRVU changes alone will impact provider productivity by upwards of 30% and disrupt medical group budgets across the country, unless adjustments are made. ECG’s experts share five ways to avert losses from these compensation models.

This session will provide the audience with:

• An understanding of the final and proposed changes for the 2021 MPFS.
• Clarity regarding the financial, operational, and contracting implications of the changes.
• A successful playbook for addressing the issues at your organization

 

The COVID-19 crisis has had a dramatically negative impact on the financial performance of physician practices. Independent practices are ill-suited to address these challenges, and many will not survive the next year. As a result, hospital-physician alignment is likely to accelerate, and executives will need to assess the antitrust considerations of the various alignment options available. In this webinar, ECG and Davis Wright Tremaine experts:

• Examine COVID-19’s impact on physician productivity, including recent month-by-month activity trends.
• Outline various partnership models that health systems and independent physicians may find attractive in this challenging environment.
• Review recent, relevant antitrust cases and explore the key factors leading to antitrust investigations.

ECG consultants Len Henzke and Stuart McClure will be joined by antitrust experts Doug Litvack and David Maas from Davis Wright Tremaine in facilitating this webinar.

 

Recent public health and economic crises have highlighted long-standing AMC (Academic Medical Center)  challenges. They have also inspired and emboldened leaders to work together to tackle politically sensitive and highly complex initiatives that have been debated for many years. In this session, ECG experts:

• Discuss how COVID-19 has exacerbated existing pain points across AMC mission areas.
• Highlight key diagnostics to rapidly identify opportunities to improve performance.
• Prioritize initiatives and define accountabilities.
• Underscore how AMC component entities can work together to achieve shared objectives.

 

An ASC with great physician partners, top-notch clinical staff, and substantial surgical volume can still struggle if its payer agreements are poorly negotiated. During this 30-minute webinar, contracting expert Matt Kilton from ECG Management Consultants and billing expert Angela Mattioda from Surgical Notes share their guidance on getting the most out of your payer contracts. They discuss examples and lessons learned from their combined 30 years in the ASC contracting and billing world.

Service line excellence and growth don’t occur organically. They are the result of purposeful planning, and these plans must dovetail with the vision, strategic direction, and strengths of the health system. The transition to value calls for health systems to rethink and redesign care delivery across services lines. But they cannot do it without the support of physicians in those service lines. Comanagement and gainsharing are complementary financial arrangements that facilitate hospital/physician alignment through enhancements in service line performance.

Learning Objectives

• Best practices in gainsharing and comanagement arrangements
• Program development approach
• Funds flow and compensation
• Valuation considerations
• Relevant legal agreements

Service line excellence and growth don’t occur organically. They are the result of purposeful planning, and these plans must dovetail with the vision, strategic direction, and strengths of the health system. The transition to value calls for health systems to rethink and redesign care delivery across services lines. But they cannot do it without the support of physicians in those service lines. Comanagement and gainsharing are complementary financial arrangements that facilitate hospital/physician alignment through enhancements in service line performance.

Learning Objectives

• Best practices in gainsharing and comanagement arrangements
• Program development approach
• Funds flow and compensation
• Valuation considerations
• Relevant legal agreements

 

While net professional collections across all physicians have remained virtually flat, clinical compensation among teaching physicians has steadily increased. Despite these increases, academic medical centers (AMCs) have not been able to keep up with compensation increases for community hospital providers and face significant recruiting challenges as a result. Additionally, academic organizations encounter serious financial sustainability concerns as they continue to find their resources stretched to subsidize their teaching and research mission. In this webinar, ECG experts will discuss the driving forces behind these trends and offer strategic and tactical approaches to help academic organizations cope.

At the end of this presentation, participants will be able to:

• Describe the physician compensation expense pressures and recruitment challenges faced by AMCs.
• Identify compensation approaches that balance market tensions against financial sustainability.
• List important considerations in incentivizing faculty for their contributions to patient care as well as their teaching and research activities.
• Distinguish best practices to acknowledge value in clinical compensation.
• Recognize opportunities to support market-level compensation for structurally underfunded departments.
• Explain compensation differences between faculty physicians and nonfaculty community physicians in the academic setting

 

Terri L. Welter and David A. Wofford address the implications of the CMS Price Transparency Rules and the resulting need for creative pricing strategies and patient-friendly value-driven payment models, in this special 45-minute HealthcareWebSummit event.

Topics Include:

• How the CMS transparency rules will (or will not) improve transparency
• Anticipated impact on consumer behavior and reimbursement rates
• The need for creative pricing strategies
• Embracing patient-friendly, value-driven payment models

 

In 2018, the median loss per physician among hospital-based specialties was more than $200,000. In this part of our webinar series, we will explore how these rising costs, both per physician and in aggregate, have spurred fundamental changes to coverage models and compensation structures as organizations attempt to create cost efficiencies without sacrificing quality and outcomes. Beyond this, we will examine how the influence of advanced home health and telemedicine will increasingly impact coverage-based models.

In this webinar, we will:

» Understand the driving forces behind the rising loss per FTE.

» Discuss how systems are dealing with these losses.

» Explore how advanced practitioners and telemedicine are influencing coverage models.

» Identify how compensation incentives have changed.

» Learn how clinical expectations and the definition of an FTE have changed over time, as well as the impact of this change.

 

Many organizations are expanding the APP footprint within their care teams to improve patient access, replace an aging physician workforce, and meet other strategic and business objectives. In doing so, organizations are focusing on operations and compensation for APPs to maximize their investment. In this session, ECG experts explore the limitations and drivers of operations and incentive alignment for APP performance.

 

In this webinar, ECG’s team of experts review the findings of ECG’s 13th annual Pediatric Subspecialty Physician Compensation Survey. The session includes our analysis of important pediatric physician and advanced practice provider performance trends from the 2019 survey and how these trends impact children’s hospitals. Included in this webinar is a discussion of market trends related to value-based care and implications for compensation planning as well as overall organization strategies.

Session Objectives

• Share the findings of the 2019 Pediatric Subspecialty Physician Compensation Survey.
• Highlight physician and APP compensation and production trends, including trends in value-based compensation, benefits, work standards, and recruiting.

 

 

The ambulatory surgery center (ASC) landscape continues to rapidly evolve, driven by market and legislative forces, patients, payers, and providers. Health systems and hospitals are under pressure from all sides to reduce costs, while changes in government regulations and commercial payer practices reward providers for migrating high‑acuity surgery to the ASC setting. This migration poses a financial threat to health systems, given the significance of surgical revenue. These combined factors motivate the need for ASCs and hospitals to develop and implement a comprehensive ASC strategy.

In this webinar, Naya Kehayes, Principal, and Sean Hartzell, Associate Principal, will discuss the current state of the ASC market, how migration is affecting hospitals’ strategic options, and how hospitals can engage in proactive strategies to survive and thrive in the changing surgical environment.

 

In this webinar, ECG’s team of experts will review the findings of our 20th annual Physician Compensation Survey. The session will include our analysis of important physician and advanced practice provider performance trends from the 2019 survey, as well as how these trends impact hospitals, health systems, medical groups, and universities/schools of medicine. Included in this webinar will be a discussion of market trends related to value-based care, as well as implications specific to compensation planning and organizational strategies overall.

Session Objectives

• Share the findings of the 2019 Physician Compensation Survey.
• Highlight physician and APP compensation and production trends, including trends in value-based compensation, benefits, work standards, and recruiting.

Organizations have evolved to accept a growing number of value-based and global-risk contracts. Across the industry, building compensation models to incentivize physicians is challenging. Further, benchmarks to evaluate physician compensation under risk-based models are lacking, making it difficult to obtain a fair market value (FMV) opinion. A value-based model asks physicians to behave differently, so we should measure performance differently. Most medical groups are inexperienced with this type of arrangement, or they lack the right tools and benchmarks. Set aside your $/WRVU models and benchmark percentiles as this on demand webinar guides you through the journey from volume to value.

This recording’s learning objectives include:

• Understanding the development success factors for risk-based agreements.
• Differentiating the issues associated with FFS models from risk-based models.
• Delineating a framework for evaluating the commercial reasonableness of value-based models.

The spectrum and prevalence of value-based payment arrangements continues to expand significantly. The financial impact of such initiatives can be in the millions of dollars for hospitals and can materially impact practitioners’ reimbursement. In this changing environment, financial models are essential to understand the impact of value-based arrangements.

This webinar focuses on trends in physician enterprise, including market factors influencing medical group financial performance and trends in benchmarking for integrated health systems. The speakers highlight findings from ECG’s 2017 Medical Group Cost and Infrastructure Survey, which identifies comprehensive operating costs and staffing benchmarks for large multispecialty system–employed and foundation-affiliated medical groups across a range of cost categories, staff functions, and operations. Metrics such as investment per physician and cost per RVU/visit are discussed.

The speakers also present case studies for how medical groups can compare themselves to appropriate market benchmarks in order to identify and prioritize performance improvement initiatives.

Specific learning objectives:

• Trends in ambulatory performance improvement
• Factors to consider when benchmarking medical group staffing and operations
• How medical groups can identify functions or areas for performance improvement within their physician organizations

Based on the ECG whitepaper, this webinar examines market dynamics that are pushing ambulatory surgery to the forefront of the healthcare delivery. Presenters highlight the ways in which health systems are looking at Ambulatory Surgery Center development and joint ventures as an opportunity to partner with physicians and other organizations to effectively implement an ambulatory surgery strategy.

With the publication of the MACRA final rule in the fall of 2016, CMS gave the healthcare industry a reprieve by allowing providers to use 2017 as a transition year. In June 2018, CMS released its 2018 proposed rule which extends this transition period, but with some important changes. Providers must adjust to avoid a negative payment adjustment and maximize their changes for enhanced earnings. This is particularly the case in complex environments involving multiple tax IDs and a mix of value-based reimbursement methodologies. This webinar is intended for audiences that are already well acquainted with the basic provisions of MACRA and are seeking concrete guidance on how best to respond.

In this webinar, ECG’s team of experts will review findings of ECG’s 17th annual Physician Compensation Survey. The session will include our analysis of important physician and advanced practice clinician performance trends from the 2016 survey. A particular focus of this webinar will be on market trends related to value-based provider compensation planning and how those plans integrate with overall organization strategies. As healthcare reimbursement transitions from volume- to value-based, it is essential that physician compensation plans also evolve to ensure organizational success under changing financial incentives.

 

In this webinar, ECG’s team of experts will review the findings of ECG’s 9th annual Pediatric Subspecialty Physician Compensation Survey. The session will include our analysis of important physician and advanced practice clinician performance trends from the 2015 survey. A particular focus of this webinar will be on market trends related to value-based provider compensation planning and how those plans integrate with overall organizational strategies. As healthcare reimbursement transitions from volume to value, it is essential that physician compensation plans also evolve to ensure organizational success under changing financial incentives.

ECG’s surveys focus on provider performance trends, including compensation, production, and benefits by specialty; compensation plan design and metrics; recruiting efforts and signing bonuses; CPT code physician profiling; and many other key performance metrics. The 2015 ECG surveys include data from 134 physician specialties and 15 advanced practice provider specialties from more than 110 physician organizations, representing more than 32,000 practitioners. Together, this data contributed to produce our most comprehensive reports to date.

 

This presentation provides an outline of ECG Management Consultant's perspective on the significance of health plan consolidation on provider organizations, and the steps they are recommending that their clients take in preparation.

Sessions include: Top Health Industry Issues for 2015; Key Healthcare Legal, Regulatory and Policy Issues for 2015; and ICD-10 as a Strategic Enabler in 2015.

Insights and perspectives on the top health industry issues for 2014; results and stakeholder implications from the 2014 Segal Health Plan Cost Trend Survey; and a discussion of collaborations between health systems as the strategic impetus for the formation of clinically integrated networks.

Key financial and operational considerations for providers to evaluate participation in exchanges.

The 2010 Accountable Care Web Summit included three faculty presentations:

• Piedmont Physicians Group Accountable Care Pilot Program - James C. Sams, MD, Medical Director, Piedmont Physicians Group
• The ACO Legal and Regulatory Environment: An Update for 2011 - Doug Hastings, Chair of the Board of Directors, Epstein Becker & Green, P.C.
• ACO Payment and Contracting Issues for 2011 - Terri L. Welter, Principal, ECG Management Consultants, Inc.