Today’s Discussion...Key market drivers impacting our industry Economy-Healthcare Costs •The...

The New Risk Bearing Models

Wednesday, November 16, 2016

Eric LevinDirector of Strategic ServicesMcKesson Business Performance Services

Shifting healthcare landscape

Current & evolving care delivery models

CMS Quality Payment Program (QPP)

Immediate opportunities

Case studies

Today’s Discussion

McKesson Corporation Confidential and Proprietary2

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In 2015, the U.S. Department of Health and Human Services (HHS):

30% of all Medicare payments tied to quality or value through alternative payments models (APMs) by 2016(achieved 3/2016)

50% of all Medicare payments tied to quality or value through APMs by 2018

85% of Medicare fee-for-service (FFS) payments will be tied to quality and value by end of 2016

90% of Medicare FFS payments will be tied to quality and value by end of 2018

By 2022, Medicare beneficiaries are expected to compose 58% of provider volumes

© 2016 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.3

Source: HHS.gov U.S. Department of Health & Human Services

Key market drivers impacting our industry

Economy-Healthcare

Costs• The overall U.S.

economic condition will continue to challenge the healthcare industry’s degree and speed of innovation.

Political-Regulatory

• Economic pressures and socio-political conditions in the U.S. will challenge the status-quo in the healthcare industry.

New Payment Models

• Healthcare payment and incentive models will continue to evolve as stakeholders test new ways incentivize better care at lower costs.

Healthcare Technology

• Big data and integrated tech platforms will drive changes in the industry in terms of how and when data is used to better coordinate care for patients.


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Value-based care: Ready or notProviders will need to effectively plan for the future while growing their patient share today


Financial risk pushed down the ladder

Patient LevelConsumer Driven (High Deductible) Plans Risk Mgmt Experience: Zero

Provider LevelShared Savings Programs/Contracts Risk Mgmt Experience: Limited

Payer LevelValue Based Network Contracts Risk Mgmt Experience: Primary Business


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Health information technology as change agent

Cloud-based (EHRs)

Big Data Analytics

Patient Centric Devices

Increasing patient demand towards greater access to and portability of their

health information

Progressive care model occurring at later stages when most needed

Supporting targeted patient outreach and engagement


Patient health status not improving

Poor health status is still a large driver of healthcare cost.

Managed Medicaid and commercial health plans focusing efforts to address these populations.

Chronic Conditions

Poor Behavioral

Health

Aging Population


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A growing network of immediate access choices

Source: Mehrota A et al, "Visits To Retail Clinics Grew Fourfold From 2007 To 2009, Although Their Share Of Overall Outpatient Visits Remains Low," Health Affairs, August 2012; Health Care Advisory Board interviews and analysis.

Traditional Access Points

RetailClinic

Urgent Care Center

Virtual Visit

Primary Care Office

Low Acuity High Acuity Emergency Department

Consumer-Oriented Service Delivery Sites Filling the Gap

9


Retail clinics expected to continue growing

1) As of Nov. 2015

2) As of July 2015

3) Clinics owned by Walmart; Walmart also leases retail space to providers in dozens of stores.

Source: Accenture, “Number of US Retail Health Clinics Will Surpass 2800 by 2017, Accenture Forecasts,” 2015; Merchant Medicine, “The ConvUrgentCare Report,” Vol. 8, No. 7, July 2015; Market Innovation Center interviews and analysis.

2000-20151

Estimated Total Number of Retail Clinics in the US

202

868

1135 1172 12201355 1418

1743 1869 1918

2000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Retailer

Operational Retail Clinics2 979 412 162 83 173

10

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Telehealth projected to grow

Sources: Herman B, “Virtual reality: More insurers are embracing telehealth,” Modern Healthcare, February 2016, available at: http://www.modernhealthcare.com/article/20160220/MAGAZINE/302209980; ”Global Telemedicine Market – Growth, Trends and Forecasts (2015-2020),” Mordor Intelligence, http://www.mordorintelligence.com/industry-reports/global-telemedicine-market-industry, December 2015; Japsen, Bruce, “Doctors’ Virtual Consults with Patients to Double by 2020,” Forbes, http://www.forbes.com/sites/brucejapsen/2015/08/09/as-telehealth-booms-doctor-video-consults-to-double-by-2020/#2d4da3675d66, August 2015; Market Innovation Center research and analysis.

16.6

26.9

2.1 5.4

14.5

21.5

2015 2020

Total

PCP Visits

Specialty Consults

$2.5

$17.6

0.0

5.0

10.0

15.0

20.0

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Year-Over-Year Medicare Reimbursement for Telehealth ServicesIn millions of dollars

Estimated U.S. Growth in Virtual ConsultsMillions of Visits

5-YRGrowth

62%

48%

157%

604% Growth


Source: Altman D, “Health-Care Deductibles Climbing Out of Reach,” Wall Street Journal, March 11, 2015, available at: www.blogs.wsj.com; Health Care Advisory Board interviews and analysis.

Higher deductibles driving increased price sensitivityMany Americans lack cash flow to cover potential out-of-pocket (OOP) costs Households Without Enough Liquid Assets to Pay Deductibles

24%

35%

Mid-range deductible Higher-range deductible1 2

“A surprising percentage of people with private insurance…simply do not have the resources to pay their deductibles.”

Drew Altman, President, Kaiser Family Foundation

More consumers attempting to find pricing information

56% Consumers who have tried to find out how much they would have to pay before getting care

67%

74%

Those with deductibles of $500 to $3,000 who have solicited pricing information

Those with deductibles higher than $3,000 who have solicited pricing information


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What will it take to succeed?

Top Healthcare Market Trends and Implications

Clinical Optimization

Practice Optimization

Practice Growth

Key Market Needs

Care Coordination and Disease Management

Patient Engagement - Care Management

Population Analytics

Physician Revenue Cycle Management

Administrative Management

Data Collection and Workflow Tools (i.e., EMR & PM)

Patient Recruitment & Retention

Physician Network Development and Participation

Actuarial Analysis

Medical Equipment & Supplies / SCM


Current Payment Models


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Fee forService

Pay forPerformance

Shared Savings

Bundle/ Episode-

Based Payment

Capitation Insurance Risk

6 PAYMENT MODELS

PaymentPer unit

Throughput

Encounter-Based

Lowest Risk /

Reward

Payment foroutcomes

Outcomes

Patient-Based

HighestRisk / Reward

Payments influence delivery modelsFrom fee-for-service to performance-based

Payment and administrative complexity grows as risk is shared

Measurement changes as accountability and data is shared

As providers take on more risk, reward also increases

Delivery model must demonstrate performance and care outcomes

DELIVERY MODELS

Medical Home ACO

Clinically Integrated Networks

Alliance Narrow Network

Continuum of value-based payment schemes

Patient-Centered

Medical Homes

Shared Savings

Programs

Capitation Arrangements

Shared Risk Programs

Provider Sponsored

Health Plans

Description

Pros

Cons

Example

Primary care-centric initiative

FFS payment plus additional PMPM

Encourages better care coordination for patients with chronic conditions

No financial incentive to improve outcomes or lower costs

Rewards providers for reducing expenditures below a benchmark

Important stepping stone for providers learning to take risk

Efficient providers that already control costs stand to gain the least

Providers and payors share in savings and excess costs

Opportunity for financial gain to the provider is higher due to level of risk

Not a one-size-fits-all program

Most providers lack adequate resources

Fixed payment from payors to take insurance risk on covered services

Significant financial incentive for providers to manage costs

Requires scale and additional resources to manage risk

A provider with an insurance license assumes 100% of the financial risk

More clinical control

Highest potential financial reward

Additional regulatory oversight

Risk-based capital Payor reaction

Increased Risk and Financial Upside

BCBS of Michigan sponsors a program with 3,600 PCPs

CMS ACO Shared Savings Program

CMS Pioneer ACO program

HCP is the largest in the country

Kaiser is the gold standard


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Source: Health Care Advisory Board interviews and analysis.

Continuum of Medicare risk models

Bundled Payments Shared Savings Shared

RiskFull Risk

• Hospital VBP Program• Hospital Readmissions

Reduction Program • HAC Reduction

Program • Merit-Based Incentive

Payment System

• MSSP Track 1(50% sharing)

• MSSP Track 2(60% sharing)

• MSSP Track 3(up to 75% sharing)

• Next-GenerationACO (80-85% sharing)

• Next-Generation ACO (optional full performance risk)

• Medicare Advantage (provider-sponsored)

Pay-for-Performance

• Bundled Payments for Care Improvement Initiative (BPCI)

Increasing Financial Risk


Care delivery models by provider type


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Interest in advanced primary care is driven by different objectives across stakeholders

Health Plan Hospital / Health System

Primary Care

Want “market balance” between health systems and independent PCPs

Want more value from primary care

Want to move to value-based reimbursement

Willing to invest, but realize providers need support

Many are looking for help Employed PCPs

– Get better employment ROI– Primary care bench strength

to manage medical risk Affiliated PCPs

– PCP relationship of choice for many health systems

– Must execute to be partners in medical risk

Prefer to remain independent Realize it is a time for them to

change – the status quo will no longer do

Need to have more time, make more money


Results & Trends


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Source: Rau J, “1,700 Hospitals Win Quality Bonuses From Medicare, But Most Will Never Collect,” Kaiser Health News, January 22, 2015, available at: kaiserhealthnews.org; Health Care Advisory Board interviews and analysis.

1) Hospital-Acquired Condition Reduction Program, Hospital Readmissions Reduction Program.

2) Value-Based Purchasing.

3) Pay-for-Performance.

Readmissions, HAC penalties outweigh value-based purchasing (VBP) bonuses

3,087hospitals in VBP program

1,700hospitals received bonus payment

792hospitals received net payment increases

After Accounting for Penalties1, Few Receive VBP2 Bonuses Estimated Net Impact of

P4P3 Programs, FY 2015

Hospitals receiving net penalties of 2% or greater

6.5%

Hospitals receiving a net bonus or breaking even

28%

Hospitals receiving net penalties between

0% and 1%

50%

The Centers of Medicare and Medicaid Innovation (CMMI) program requires orthopedic bundling in 67 select markets

Key Program Features

Mandatory in 67 markets

No application process; CAHs and BPCI Phase II participants exempt

Retrospective bundle

CMS will pay each provider separately, conduct annual reconciliation process

Comprehensive episode

Includes all related Part A and Part B services for 90 days post-discharge

The Comprehensive Care for Joint Replacement (CJR) Model

Focus on joints

Average expenditure varies from $16,500 to $33,000 by geography

Program Timeline

July 2015

Program announced; comment period through September 8th

April 2016

First performance year begins; no episode discount for first year

2017-2020

Downside risk incorporated; 1% discount in 2017, 2% for 2018 onward

$153MEstimated savings to Medicare over the 5 years of the model

Source: Centers for Medicare and Medicaid Services; Advisory Board interviews and analysis.


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19

404 423

89 ACOs join in 2015, few generating shared savings in first year

Source: Spitalnic P, “Certification of Pioneer Model Savings,” CMS, April 10, 2015; available at www.cms.gov; “Shared Savings Program Fast Facts,” CMS, April 2015, available at: www.cms.gov; CMS, “Fact Sheets: Medicare ACOs continue to succeed in improving care, lowering cost growth,” September 16, 2014, available at www.cms.gov; McClellan M et al., “Changes Needed to Fulfill the Potential of Medicare’s ACO Program,” Health Affairs Blog, April 8, 2015, available at www.healthaffairs.org/blog; Health Care Advisory Board interviews and analysis.

Medicare Shared Savings Program (MSSP) continues to grow despite mixed results

Medicare ACO Program Growth Continues

26%

27%

46%

One-Quarter of MSSP ACOs Share in SavingsFirst Performance Year

Held Spending Below Benchmark, Earned

Shared Savings

Reduced Spending, Did Not Qualify

for Shared Savings

Did Not Hold Spending Below

BenchmarkPioneer ACO MSSPACO

TotalMedicare ACOs

As of April 2015


Track 1 Track 2 Track 3

• Option to renew for second three-year term

• Savings rate reduced to 40% for second term

• Shared savings, loss rate remains at 60% based on quality performance

• Revises MSR and MLR from fixed 2% to variable 2%-3.9% based on number of beneficiaries

• Beneficiary attestation

• Shared savings up to 75%, shared losses from 40%-75% based on quality performance

• Fixed 2% MSR and MLR

• Prospective assignment and beneficiary attestation

• Program waivers

Proposed tracks for the Medicare Shared Savings Program (MSSP)

Source: Davis Wright Tremaine, “Keeping Track of the Tracks: Proposed ACO Regulations Alter MSSP Financial Models,” December 11, 2014, available at www.dwt.com; McDermott, Will & Emery, “CMS ACO Proposed Rule to Extend One-Sided Risk Track While Incentivizing Performance-Based Risk,” December 19, 2014, available at www.mwe.com; Health Care Advisory Board interviews and analysis.

Key Takeaways for Providers

• Encourages providers hesitant to assume downside risk to remain in program; reduces long-term attractiveness of upside-only contracts

• Track 3 provides options for providers to quickly assume more risk

• Provides flexibility for organizations with varying capabilities to assume risk

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Source: KFF, “Medicare Advantage Fact Sheet,” June 29, 2015, available at: www.kff.org; McKinsey & Co., “Provider-Led Health Plans: The Next Frontier—Or the 1990s All Over Again?”, January 2015, available at: healthcare.mckinsey.com; MedPac, “Do new Medicare beneficiaries choose Medicare Advantage right away?” Sept. 15, 2014; Health Care Advisory Board interviews and analysis.

1) Medicare Advantage.

Medicare Advantage (MA) continues record growth

10.4M(13%)

16.8M(31%)

30.0M(40%)

202520152005

MA1 Enrollment to Nearly Double by 2025Total Enrollment and Percentage of Total Medicare Population

MA Penetration Varies by StateTotal MA Enrollment as a Percent of Total Medicare Population, 2015

0%-10% 10%-19% 20%-29%

states currently have provider-led plans in their markets

39of provider-led plans offer MA coverage options

69%of newly eligible beneficiaries chose MA in 2012

24%

30%-39% 30%-39%

Source: Health Care Advisory Board interviews and analysis.

Employers investing in different models

Four Primary Models for Controlling Employee Utilization

ACO networks:Employer contracts with single delivery system based on promise of reduced cost trend

Manage Costs at Point of Network Assembly

“The One-Stop Shop”

Enhanced primary care: Employees directed to PCPs with proven ability to reduce utilization, refer responsibly

“The Accountable Physician”

Personal health navigators: Guide employees through all health care related decisions, refer to high-value providers

“The Neutral Third Party”

“The Second Opinion”

Specialty carve-out networks: Employees evaluated against appropriateness of care criteria, sent to centers of excellence

Manage Costs at Point of Referral, Point of Care


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CMS Payment Reform


The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a bipartisan legislation signed into law on April 16, 2015.

MACRAQuality Payment Program (QPP) set to begin January 1, 2017

What does MACRA do?• Repeals the Sustainable Growth

Rate (SGR) Formula

• Changes the way that Medicare rewards clinicians for value over volume

• Streamlines multiple quality programs under the new Merit-Based Incentive Payments System (MIPS)

• Provides bonus payments for participation in eligiblealternative payment models (APMs)


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APMs are new approaches to paying for medical care through Medicare that incentivize quality and value.

• MACRA does not change how any particular APM rewards value.• APM participants who are not “QPs” will receive favorable scoring under

MIPS.• Only some of these APMs will be eligible APMs.

Alternative Payment Models (APMs)

CMS Innovation Center model (under section 1115A, other than a Health Care Innovation Award)

MSSP (Medicare Shared Savings Program)

Demonstration under the Health Care Quality Demonstration Program

Demonstration required by Federal Law

According to MACRA law, APMs include:


The MIPS is a new program that combines

parts of the these incentive programs:

Physician Quality Reporting

System (PQRS)

The Value Modifier (VM or Value-based Payment

Modifier)

The Medicare Electronic Health Record (EHR)

incentive program

This single program, MIPS, will measure Eligible Clinicians

(ECs) on:

Quality

Resource use

Clinical practice improvement

Meaningful use of certified EHR technology

88% of physicians1 are expected to fall under

MIPS vs. APMs

Merit-Based Incentive Payment System (MIPS)


1 - http://www.modernhealthcare.com/article/20160813/MAGAZINE/308139982

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MIPS performance categories

A single MIPS composite performance score will factor in 4 weighted performance categories on a 01-100 point scale


MIPS Composite

Performance Score (CPS)

Quality Resource use

Clinical practice improvement

activities (CPIA)

Advancing care information

Source: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Quality-Performance-Category-training-slide-deck.pdf

Four options to comply with MIPS or APMs


CMS’ recent “pick your pace” options for QPP Offering providers MACRA flexibility in 2017

Source: https://blog.cms.gov/2016/09/08/qualitypaymentprogram-pickyourpace/

Option 1: Test the quality payment program

Option 2: Participate for part of the calendar year

Option 3: Participate for the full calendar year

Option 4: Participate in an Advanced Alternative

Payment Model in 2017

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Six points for MACRA implementation


1. Get Started – January 1, 2017 impacts 2019 reimbursement.2. Out of the 4 categories focus on Cost/Resource Use as that

will be the differentiator compared to Advancing Care Information (ACI), Quality, and CPIA.

3. Factor alternative payment model (APM) participation bonus into risk-based payment model adoption strategy.

4. Understand which reimbursement model and “pace” your organization will likely fall into.

5. Educate providers in your group on your reimbursement model and what it means for provider payment in 2019.

6. Stay current on forthcoming CMS proposed and final MACRA implementation rulings.

• As US healthcare shifts to value-based reimbursement, chronic care management (CCM) is a main focus

• CCM is the first step for many providers on the path to value-based care and reimbursement

• Provides new opportunity to improve quality of care and increase efficiencies

Pay-for-performance shift for chronic disease


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Goal:CMS has acknowledged the importance of chronic care

management (CCM)• Patient outcomes

• Cost savings

How:Under CPT® code 99490, CMS

pays separately for monthly, non-face-to-face care coordination

services furnished to Medicare beneficiaries

with 2 or more chronic conditions.

Who can perform:Services can be

fulfilled by the clinical staff or performed by a third party.

Services are billed under the provider.

Financial reimbursement:Average reimbursement

from CMS for a CCM care coordination event is approximately

$40.00 per enrolled patient per month.


Chronic care management (CCM) at glance

CPT® is a registered trademark of the American Medical Association.

• CPT Code 99490

• TCM Code 99495 & 99496

• 93% of Medicare FFS spend is on poly-chronic population**

• For MIPS:• Hit 33 measures under Quality*

o 22 High Priority measures

• Fulfills some Clinical Practice Improvement Activities (CPIA)

• Addresses cost/resource use through decrease in avoidable interventions

• Requires EHR to operationalize, which ties back to Advancing Care Information (ACI)

CCM and MIPS


2/3 of Medicare beneficiaries have 2 or more chronic conditions

*Based upon final ruling** Becker’s - http://www.beckershospitalreview.com/legal-regulatory-issues/preparing-for-macra-top-3-priorities-for-2016.html

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Case Studies


BCBSAZ – McKesson joint venture (JV) structure

JV/Equity Owner • Plan marketing to beneficiaries• Benefits administration & claims data• Funding grants to physicians - ~

average $19k per provider funding over 5 years

Value-Based Clients (AZ Clinicians)Gain Share

JV/Equity Owner • Exclusive service provider to ACO Partner • Care coordination, navigation, and disease

management• Strategic management and analytics

services• Network development and physician

engagement• Practice transformation and coding• Care coordination• Technology (Risk Manager, Vital Care

Management)


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“A multi-specialty group in Connecticut with over 115 healthcare providers from primary care to sub-specialty care in 36 locations

Highlights

NetworkGrowth

• Started at $15M, grew to $40M in 2011, budgeted $65M in 2013

• More than doubled in size and today includes over 115 healthcare providers

• Built surgery and sleep centers resulting in combined annual revenues of over $5M

Technology • Consolidated to single practice management softwareplatform

• Meaningful use incentive over $1M in 2012• Developed data warehousing and advanced analytics

Revenue Cycle Management

• Consolidated and centralized billing and collectionoperations

• Standardized policies and procedures• Introducing patient balance estimator tools to

facilitate a more effective patient pay process

Medicare shared savings program ACO

Recent ACOs

• Genesee County ACO (2013 filing)

• Chrysalis ACO (2014 filing)


“

SeaView independent physician association (IPA) in California delivers care to members in multiple health plans through a network of over 300 independent primary and specialty care physicians

Highlights

Results • Revenues have increased over 75%, to $87 million• Physician bonuses have increased over 230% to

$10 million• Primary care physicians earn about 25% more than

if they contracted directly with Medicare

Membership • Grew and manage a membership of 49,500 commercial enrollees, plus 8,050 Medicare Advantage Members,

Full Scope of Services

• Network Contracting• Provider Relations• Utilization Management• Case Management• Claims Adjudication and Payment• Pay for Performance Administration• Electronic Health Records• Data warehousing

SeaView IPA

Commercial


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“• Six hospitals in

Omaha, Council Bluffs; 18 hospitals across Nebraska and southwest Iowa

• 2000 independent and employed

• 550,000 total lives

Highlights

Critical issues • In experience with risk-based payment models• Inability to stratify patients by risk and cost• Lack of visibility into out-of-network claims

Technology • Population and Risk Management

Results • Reduced costs by as much as $5 million annually• Can easily identify high –risk members, services

and drugs on-demand• Care mangers now have a unified view of risk, cost

and quality for each patient

UniNet Healthcare Network

Population health technology


Steps to Take Now


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Act now

Know who you want to be in 5 years

There is no question where we are heading

Over 430 MSSP ACOs, 20 Next Generation ACO model

Over 90%of payers have introduced some form of value-based reimbursement (VBR) – MHS/ORC Research

Take advantage of the paid-for education on VBR

of physicians are reimbursed solely on

fee-for-service (FFS) –MHS/ORC Research

Only 3%


Focus on chronic care management (CCM)5% drives 50% of total costs

COMPLEXCARE

Patients with multiple,ongoing medical and social concerns.

CASE MANAGEMENTPatients with acute, time-limited medical needs.

DISEASE MANAGEMENTPatients with single (or non-complicated) chronic conditions.

PREVENTIVE HEALTHWellness support and preventive services for healthy patients.

California Quality Collaborative


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Transitional care management (TCM)

18% national readmission rate

Equates to over $15B in healthcare spend annually

Readmission penalties & public visibility


The CCM/TCM workflow


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Multi-pronged strategic approach to value-based care delivery

Launch multiple initiatives simultaneously

Not just an MSSP ACO add commercial lives/ACO

Not just a Chronic Care Management (CCM) add Transitional Care Management (TCM) initiative

Innovate the way you’re paid –CPC+ introduces FFS model with prospective payments

Unite the culture by assigning numbers to leaders – i.e. 50% of your patients/services should be on VBR (P4P, Shared Savings, Bundled, etc.) by 2019

Find your “Paid for Petri Dishes”


Payer alignment

Get on the same side of the table

Develop consensus with all payers on your reporting for any VBR contract – AHIP/CMS provides guiding light

Introduce new risk-based reimbursement models with manageable populations –retroactive analysis to see if you’re predictable

Bridge FFS to VBR in stages with higher-risk commercial populations – shared savings, CPC+-esque

Turn your data into actionable information – payer collaboration

Learn from payer mistakes –program efficacy, capital allocation, and data analysis


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Patient outreach campaigns for improvement of HEDIS, P4P, ACO, PQRS, Stars and CAHPS


Chronic condition call campaigns (diabetes, high blood pressure, COPD, asthma, etc.)

High risk diabetes patients not seen in 6 months with high HgA1c

Prenatal and postpartum care

Post Discharge Management

HCAHPS surveys

Annual Wellness Visits & Health Risk Assessments

Provide 24/7 clinical access

Medication compliance and reconciliation

Immunizations and Flu shots

Tobacco prevention and cessation

Appt scheduling for revenue generation campaigns

Create the culture of a positive patient experience•ED room wheelchairs

Prioritize tasks across all their patients’ needs

Empower patients to collaborate in their care with their providers

Employ the right technology •20% of U.S. adults currently have access to their medical records online

Efficacy and ROI (Cost Benefit Analysis might be needed) must be primary– what truly works for your patients and is it sustainable

Eliminate paperwork and wait times•Pre register, bring into exam room early

New reimbursement models lead to new locations of care delivery•Telehealth, on demand, in home visits

Smarter patient engagement


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Take advantage of Upside programs

now

Focus on quality, and the dollars will

follow

Identify opportunities to

increase inexpensive encounters

Expand partnerships with technology and service vendors

Monumental shift in care delivery and

incentives

Commercial payers will continue to

follow CMS’ lead (value-based

reimbursement)

Key takeaways



Thank You!Eric Levin

[email protected]

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Today’s Discussion...Key market drivers impacting our industry Economy-Healthcare Costs •The...

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Transcript of Today’s Discussion...Key market drivers impacting our industry Economy-Healthcare Costs •The...