At the Helm

Insights for the C-suite

RAND says MACRA could hurt hospital revenue by $250 billion. Here's our take.

Eric Cragun , Yulan Egan April 14, 2017

There's a new study out in Health Affairs that could put hospital and health system leaders on edge.

RAND Corporation researchers found that under MACRA, Medicare spending on hospital services through 2030 could fall by up to $250 billion—or increase by up to $32 billion. They also found that Medicare spending on physician services could fall by $35 billion to $106 billion.

Here are our big takeaways from the study.

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A new formula to track the ROI of your employed physicians

by John Deane, MPA and Adam Bryan, MBA, Advisory Board Consulting April 4, 2017

When thinking about the financial performance of the employed physician enterprise, is your first instinct to focus on the operating loss of the medical group as a standalone business? While this is certainly an important part of the equation, it's by no means the whole story.

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4 things you need to know about the House GOP plan to replace the ACA

Eric Cragun March 7, 2017

On Monday, House Republicans unveiled the "American Health Care Act" (AHCA), which would repeal, replace, or adjust some elements of the Affordable Care Act—but leave many elements of the ACA intact.

Our early assessment of the bill suggests some key themes for providers as they navigate changes to the health care industry, including potential increases in uncompensated care and an accelerated shift toward consumerism. However, the proposal has been public for less than 24 hours and faces a long road before any elements would become law, key caveats for any discussion of the legislation.

We will continue to provide more analysis as we learn more and as the bill evolves. Join us next Friday for a webconference on the legislation and/or attend one of our remaining Health Care Advisory Board National Meetings, where we'll be discussing the plan and the no-regrets priorities for health systems, regardless of what happens in Washington, D.C.

Register for the March 17 webconference

Here are four things providers need to know about the House GOP plan:

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How to assess the decision to switch EHR systems

March 1, 2017

by John Kontor, MD

With almost any industry, there are a few companies that have the majority of market share. We're all familiar with the dominant players in the EHR market, those top 10 systems who hold the 80-90% of market share year to year. According to market research Epic, Cerner, and Allscripts currently top that list.

I can't tell you how many times I get asked, "Should I just switch to Cerner or Epic or Allscripts?" by health IT executives whose health system uses an EHR other than one of these major systems. Health system leaders should take a close look at their current situation alongside their short and long-term objectives to determine the right answer for their organization—with only a little consideration for what's popular in the market.

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151 years and 3 ACOs later, here's where Tom Zenty is taking University Hospitals next

by Eric Larsen, Managing Partner, and Liz Hughes, Managing Principal February 22, 2017

Welcome to the "Lessons from the C-suite" series, featuring Managing Partner Eric Larsen's conversations with the most influential leaders in health care.

In this edition, Tom Zenty, CEO of University Hospitals, talks to Eric and Managing Principal Liz Hughes about how Tom knew he wanted to go into health care administration at age 15, why he has a Charles Darwin quote in his office, and how his system is approaching the "new age of consumerism."

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5 things providers should know about new HHS Secretary Tom Price

Eric Cragun February 10, 2017

Early Friday morning, the Senate voted 52-47 to confirm Tom Price as Secretary of the Department of Health and Human Services. Here's what providers should know about Price and how his time at HHS might affect their strategy.

Secretary Price now assumes leadership of a department that controls over $1.1 trillion in annual federal spending and includes CMS, FDA, and NIH, among other agencies. The Senate Finance Committee will hold a hearing next week to consider the confirmation of Seema Verma, President Trump's nominee for CMS Administrator. The president has yet to announce his nominees for FDA commissioner and NIH director.

In his new role, Secretary Price clearly will have a significant impact on the health care industry. So what should providers know about Price and how his time at HHS might affect their strategy?

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Our vision for transforming health care: It starts with you

Robert W. Musslewhite February 2, 2017

All of us who work in health care are well-versed in change, and this year has ushered in a period of particular uncertainty—and opportunity—for our members. That's one reason why I'm eager to share with you the vision for our work in 2017 and beyond.

As always, your challenges are our challenges, and your goals are our goals—and now we are better positioned than ever to help you tackle them.

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How to interpret Trump's executive order regarding the ACA

Eric Cragun January 23, 2017

On Friday—in between the inaugural parade and inaugural balls—Trump issued an executive order that directs federal agencies to take steps to ensure the government's implementation of the ACA minimizes the burden on impacted parties (individuals, states, etc.).

The order instructs agencies to "waive, defer, grant exemptions from, or delay implementation of provisions" that place a "fiscal burden on any State" or that impose a "cost, fee, tax, penalty, or regulatory burden" on stakeholders including patients, providers, and insurers. Importantly, the order states that any changes should be made only to the extent "permitted by law" and should comply with the law governing administrative rule-making.

The order does not, however, provide specifics on next steps or provisions that will be reexamined. Predicting how agencies and their new heads will respond to this order is impossible at this point. The quick take is that the order is best viewed as a symbolic step reaffirming Trump's focus on repealing the ACA and an effort to show that he is keeping his campaign promise to deal with the ACA on his first day.

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