Marc Iampieri’s Post

Private equity got excited about value-based care in the waning days of the pandemic, and now it's time make good on the promise of better, cost-effective, integrated care. But in a highly inflationary environment, that is proving tough. Between elevated claims expense, operating costs, and other SG&A, providers need to finesse their footprint, payor contract negotiations, MRA scores, and operational model to deliver the "value" in VBC. Done well, both the patient and their primary-care practice will benefit. Our experts Jerry Wang and Colin Dmochowski outline 5 steps operators can take to improve cost - read the full article here:

Private equity got excited about value-based care in the waning days of the pandemic, and now it's time make good on the promise of better, cost-effective, integrated care. But in a highly inflationary environment, that is proving tough. Between elevated claims expense, operating costs, and other SG&A, providers need to finesse their footprint, payor contract negotiations, MRA scores, and operational model to deliver the "value" in VBC. Done well, both the patient and their primary-care practice will benefit. Our experts Jerry Wang and Colin Dmochowski outline 5 steps operators can take to improve cost - read the full article here:

Private equity got excited about value-based care in the waning days of the pandemic, and now it's time make good on the promise of better, cost-effective, integrated care. But in a highly inflationary environment, that is proving tough. Between elevated claims expense, operating costs, and other SG&A, providers need to finesse their footprint, payor contract negotiations, MRA scores, and operational model to deliver the "value" in VBC. Done well, both the patient and their primary-care practice will benefit. Our experts Jerry Wang and Colin Dmochowski outline 5 steps operators can take to improve cost - read the full article here:

Private equity got excited about value-based care in the waning days of the pandemic, and now it's time make good on the promise of better, cost-effective, integrated care. But in a highly inflationary environment, that is proving tough. Between elevated claims expense, operating costs, and other SG&A, providers need to finesse their footprint, payor contract negotiations, MRA scores, and operational model to deliver the "value" in VBC. Done well, both the patient and their primary-care practice will benefit. My colleague Colin Dmochowski and I outline 5 steps operators can take to improve cost - read the full article here:

Daily VBC Wire January 20, 2025 - Healthcare Consolidation Recently HHS released a report detailing work they did in conjunction with other departments regarding consolidation in healthcare and the negative impacts of private equity (PE) and other investment mechanisms on healthcare delivery systems. The reports identifies a few areas that these consolidation efforts have had the worst impact: - price increases on services - upcoding and increases in unnecessary tests and treatments - high margin specialities targeted for consolidation - short term investments leveraging debt leading to bankruptcy of companies acquired Hard to say how more consolidation will take place over the next four years under a new administration but I think it’s safe to say it is not going away any time soon. We may see shifts in where the investments take place and some policy changes but if there is profit to be made, investors will go after it.

🚨 Must-Read Investigation by The New York Times 📰 A recent probing article in The New York Times has unveiled concerning practices by MultiPlan and key insurers like UnitedHealthcare, Aetna, and Cigna. The investigation highlights how these entities potentially burden patients with large bills while cutting payments to out-of-network providers, a strategy that appears to significantly benefit MultiPlan. 📉 According to the report, MultiPlan claims to have saved billions last year, yet these 'savings' often result in disproportionately high fees retained by MultiPlan, far surpassing what is actually passed down to healthcare providers. 📢 The American Hospital Association has called for a federal investigation into these practices. This is a crucial step toward ensuring transparency and fairness in healthcare reimbursement. #HealthcareReform #FairReimburement #OutofNetwork #NoSurprisesAct #IndependentDisputeResolution

Alignment Health and Clover Health, recently reported significant membership growth and positive financial results, highlighting their strong performance in a competitive landscape. Alignment Healthcare experienced a 35% year-over-year increase in membership, surpassing initial expectations. The company is focused on expanding its presence in existing markets and entering new states, with a goal of reaching adjusted EBITDA profitability in 2025. Alignment emphasizes a value-based approach to care delivery, focusing on improving patient outcomes and controlling costs. Clover Health saw a 27% year-over-year increase in membership, driven by strong performance in New Jersey. Clover achieved high-ranking HEDIS clinical quality scores, demonstrating the effectiveness of its care delivery model. The company emphasized the role of technology, including its Clover Assistant platform, in improving care delivery and enhancing patient outcomes. Learn more: https://hubs.ly/Q032RXLw0

Are You Prepared for Medicare Advantage Market Upheavals? Market disruptions are neither new nor a thing of the past; they are here to stay and costly if you’re not equipped with a thorough response plan to protect patient relationships. Health plan contract terminations, plan pullouts, mergers, and acquisitions threaten your Medicare patient base. Retaining patients requires smart planning, ongoing patient engagement, a systemwide commitment, and a focused communications strategy. Mobilizing with speed and an ability to pivot if the insurer pulls a surprise, can make a difference in smooth patient/plan transitions while minimizing administrative hassles and market share loss. MedicareCompareUSA and its consulting division—MCUSA Communications—have helped hundreds of hospitals and medical groups around the country successfully tackle such upheavals; and we can assist you, too. We have the track record of helping navigate changes in MA network participation and can help you provide patients with clear and compliant Medicare information. We’re the nation's leader in helping healthcare organizations prepare, implement, and achieve Medicare strategies geared toward Medicare population management, retention, and growth. We're here to help. Contact us today. https://lnkd.in/gFSrDQKf

Good morning Healthcare, This article is positive news for the Healthcare Industry. Not necessarily for staffing but for Hospitals. There could be a trickle down effect that benefits staffing however. A quote: "Despite a slowdown in 2024, healthcare M&A activity remained nearly 70% higher than pre-pandemic levels. There were 1,373 healthcare deals in 2024." https://lnkd.in/gYvQqbfw

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