Select Progressive Insights:
rEIMBURSEMENT
Key Medicare Changes for 2024 - Final Ruling A summary of the final rule Medicare changes for 2024, including payment adjustments across all major health settings.
Key Medicare Changes for 2023 A summary of the key Medicare changes for 2023, including payment adjustments across all health settings, changes to Telehealth coverage, 340B outpatient payment adjustments, and more.
Medicare Site-Neutral Payment Updated for Final Rule
HFMA article on 2017 Medicare limits to “reimbursement arbitrage” for most outpatient services, including new off-campus locations and services.
MACRA, The Changing Nature of Medicare Reimbursement
Overview of Medicare’s first move (for physicians) into “value-based care”.
340B AND MEDICATION MANAGEMENT
Optimizing 340B for a Hospital’s Own Health Plan Members How a 340B-eligible health system can leverage its control of its own health plan to lower its net drug benefit costs by increasing the compliant-usage of 340B by integrating data from both the health plan’s PBM and the Covered Entity’s 340B vendor.
Big Pharma’s Efforts to Kill 340B and Tactics for Hospitals The pharmaceutical industry has long opposed the 340B program. Since July 2020, several large drug manufacturers have attacked the 340B program. This document will be updated on a regular basis. This document will be updated on a regular basis.
Reducing the Cost of Employee Prescription Drugs
Discussion of tight PBM Vendor Management as a tangible method to reduce employee prescription drug costs.
Strategy
FORWARD: A Data-Based Path to the C-Suite
Future career advancement in strategy and marketing will be based on demonstrated expertise in other areas.
Strategic Planning, A Catalyst for Change
Most organizations lack effective strategic planning and hospitals face both unique and growing challenges. To complete effectively, hospitals must change how they “plan” which, in turn, will require organizational/cultural changes.
Ten Things to Know About High Impact Leadership Retreats
Retreats present a unique forum to design and refine an organization’s strategy. Effective retreats enhance a health system’s market positioning, execution, culture and decision-making.
Care Management - ACO and CIN Development
Clinical Integration, What and Why
Discussion of the primary components of Clinical Integration and differentiation between Clinical Integration and Managed Care. This document also explores the relationship of Clinical Integration to Population Health.
Clinical Integration, Why You Should Care
Detailed description of Clinical Integration; the rationale behind it and how ACOs "fit in"; and recommendations for providers to address the unrelenting pressure by all payors to reduce total medical expenditures.
Clinical Integration & Accountable Care Organizations
Discussion of the use of both short- and long-term plans for Clinical Integration as common tactic to differentiate a network of providers. Includes a thorough background of clinical integration and ACOs, as well as our observations and approach.
Care Management Via Clinical Program Design
Best Practices - Digestive Disorder Programs
Overview of best practices and features for the top programs in the US.
Best Practices - Endocrinology & Diabetes Programs
Overview of best practices and features for the top Endocrinology and Diabetes programs in the US.
Best Practices - Heart Failure Programs
Overview of best practices and features for the top Heart Failure programs in the US.
Managing Heart Failure as a Business
Detailed analysis of the financial aspects of treating patients with HF and a key paradigm shift to pro-actively manage care fand address the financial drain experienced by hospitals.
AMBULATORY SURGERY CENTER
Ambulatory Surgery Centers in the Current Healthcare Environment With 75% of surgeries nationally being performed on an outpatient basis, ASCs are becoming even more substantial as part of an overall outpatient strategy. Learn more about Progressive Healthcare’s ASC offerings.
Transformation of Healthcare: Moving past the Hype and Leveraging "ACO" Initiatives for Competitive Advantage Steps to achieve strategic objectives via ACOs.
Issue 2: How 20% of Non-emergent/Elective Procedures can be Performed without Physician Involvement by 2040 This is the second in a quarterly series of thoughts that are intended to stimulate discussion and strategy.
Issue 1: Misalignment of Surgery Supply & Demand in the US This is the first in a quarterly series of thoughts that are intended to stimulate discussion and strategy.