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Providers represented by the American Medical Group Association (AMGA) expect more of their business to come from risk-based products in 2019, with government revenues moving from Medicare fee-for-service (FFS) towards Medicare Advantage and shared risk accounting for a greater share of revenue in commercial settings.

Millennial patients know less about their health benefits, are less likely to pay their medical bills in full and often don’t save for medical expenses, according to a survey published by TransUnion Healthcare.

St. Louis-based Ascension Health and Renton, Washington-based Providence St. Joseph Health are discussing a merger, according to the Wall Street Journal, which would create a massive nonprofit health system of 191 hospitals in 27 states.

More than a year after first announcing they were negotiating a merger, Dignity Health and Catholic Health Initiatives (CHI) have a definitive agreement to create a massive nonprofit health system based out of Chicago with more than $28 billion in combined revenue.

CMS reported national health spending grew at a slower rate in 2016, increasing by 4.3 percent with slower growth across almost all spending categories, including private health insurance, Medicare, Medicaid and retail prescription drug spending.


Recent Headlines

Q&A with HFMA’s Richard Gundling: Key Financial Issues in 2013

More than any other concept in health care, value has become a guiding principle for health care leaders and stakeholders as they wade into the era of health care reform. To assist health care financial leaders in their drive to value, the Healthcare Financial Management Association (HFMA) launched the HFMA Value Project, yielding a collection of case studies, presentations, and assorted educational resources that can be found on its website. HealthCXO spoke with HFMA’s Richard Gundling, VP, Financial Healthcare Practices, to identify the key financial issues facing hospitals and physician practices in 2013.

Uncompensated Care: Sharp Healthcare Turns ED Losses into Gains

In 2009, the recession was in full swing, unemployment rates were high, and health care facilities were providing more than $39 billion a year in uncompensated care for the uninsured. Instead of riding out the recession with uncertainty and accruing more debt, Sharp HealthCare (San Diego, California) joined forces with the nonprofit Foundation for Health Coverage Education (FHCE) (San Mateo, California) to meet the problem head on. Sharp leveraged a Web-based eligibility software program and took on a strong patient advocacy role to provide uninsured patients with much-needed eligibility assistance.

Analyst Forecasts Continuing Headwinds in Health-care Financial Markets

Consolidation, the implementation of the Patient Protection and Affordable Care Act (PPACA), and efforts to use capitation for Medicare patients will all have an impact on health-related stocks, over then next few years.

Serving Low-income Patients Inland Empire Health Plan’s PPACA Strategy

One of the most contentious issues associated with the Patient Protection and Affordable Care Act (PPACA) has been the creation of health insurance exchanges (HIEs), which must be composed entirely of private health insurers. While many states have resisted participation, others, like California, have begun building an exchange.

M&A Part II: Practical Considerations of the Deal

In the hospital space, as in other markets, mergers and acquisitions (M&A) can be fraught with emotion. However, setting feelings aside and concentrating on practical matters—especially unique challenges that are inherent in merging with or acquiring a particular type of institution—are essential to deal-making success.

Vetting a Partnership: When to Consider a Merger or Acquisition

Health care reform has catalyzed providers—especially independent hospitals—to consider the business models and structures within which they will operate going forward. As such, many will contemplate mergers or acquisitions, but there is much to consider before pursuing such a path.

WellPoint Founder: Health Reform Law Is Not Enough

Leonard Schaeffer, founding CEO and former chairman of WellPoint insurance company, gave a sobering opinion on the ability of the federal reform legislation to bend the health care cost curve at The 8th Annual American Health Care Congress and Exhibition.

Hospital Employment: What Hospitals and Physicians Should Know

American physicians are again rushing to become employed by hospitals—and hospitals are responding in kind, says D. Louis Glaser, JD, partner with Katten Muchin Rosenman LLP in Chicago, Illinois. "The trend is being driven by the uncertainty of the future," he says. "Physicians and hospitals are wondering how reimbursement is going to change,

OhioHealth: Creating a High-performance Revenue Cycle

When Jane Berkebile, vice president of revenue cycle for OhioHealth (Columbus, Ohio), joined the organization five years ago, she was already impressed by its revenue cycle performance. “The triad for success, as I call it, was up and running when I came here: patient access, medical records, and business office activities were all reporting to the

Leadership and Succession Planning for Health Care

Multiple factors stand to shake up health care organizations' leadership structures in the coming years, says Will Powley, senior consulting leader with GE Healthcare's Performance Solutions group: economic recovery, health care reform, and, perhaps with the most impact, the impending retirement of the Baby Boomer generation. Combined, these three