GeBBS Healthcare Blog

By Nitin Thakor, GeBBS President & CEO

There is much discussion today on what is going to happen to the Medicaid program. Congressional Republicans and President Trump are seeking to repeal and replace the Affordable Care Act (ACA) and Medicaid is a large part of that program.

By Nitin Thakor, GeBBS President & CEO

Cigna ended its merger agreement with Anthem on Valentine’s Day and said it will seek $13 billion in damages from Anthem on top of the $1.85 billion break-up fee outlined in the deal. The planned $54 billion merger was blocked by a federal district court last week on anti-competitive grounds. Cigna said the reason for the break-up was that the potential alliance cannot and will not achieve regulatory approval and was calling off the deal in the best interest of its shareholders. Industry analysts are projecting that Anthem will not pay the break-up fee without a fight.

By Nitin Thakor, GeBBS President & CEO

A Healthcare Finance News article last year quoted a New Jersey hospital executive as saying: “Big is going to be better; small is not going to survive.” Time will tell if he is right, but most industry analysts agree that the coming year will be full of acquisitions and mergers as hospitals, health systems, information technology companies, software firms, medical practices and other healthcare service providers seek to discover whether or not bigger is indeed better in the new world of the Affordable Care Act (ACA) -- and whatever evolves from its planned repeal and replacement.

By Nitin Thakor, GeBBS President & CEO

AHA President and CEO Rick Pollack recently sent a congratulatory letter to President-elect Donald Trump and asking him to go slowly on changes to our healthcare delivery system, particularly when it comes to the Affordable Care Act (ACA). This is good advice since healthcare represents a significant portion of the U.S. economy and essential public services. Pollack explained his case in terms that abrupt changes could lead to significant instability for patients, providers, insurers and others.

By Nitin Thakor, GeBBS President & CEO

In a recent blog we asked that CMS go slowly with the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA), a landmark payment system for Medicare physician fees that replaces the sustainable growth rate formula.

By Nitin Thakor, GeBBS President & CEO

Some lawmakers are warning the CMS that its Medicare Access and CHIP Reauthorization Act (MACRA) draft rule on new physician payments could significantly harm small physician practices. When MACRA goes live in 2019, it is supposed to improve healthcare delivery by giving bonuses to top-performing doctors and clinicians and provide negative incentives for underperformers on a variety of measures, especially quality of care. However, many people in the healthcare industry believe that MACRA will have a net negative effect on care delivery and cause many small practices to close their doors or consolidate with other practices, which will undoubtedly lead to higher healthcare costs.

By Nitin Thakor, GeBBS President & CEO

I was struck by recent article in the New England Journal of Medicine Catalyst entitled: “How Multi-Specialty Hubs Fill a Major Gap in the Care Continuum.” The article brings out a fact that all of us in the healthcare industry need to take to heart, and that is: how can we “think outside of the box” and take advantage of the resources we presently have and use them to improve care and reduce costs.

By Nitin Thakor, GeBBS President & CEO

A relatively new phenomenon in healthcare has the potential to negatively impact hospitals’ revenue stream. This new phenomenon is called the freestanding emergency department (FSED). We know that market share in any hospital marketing area is critical to the facility’s success. If a competing FSED opens in a hospital’s market area it will surely impact the hospital’s revenue.

With the growing number of high deductible insurance plans and the Affordable Care Act (ACA), patients are now responsible for up to 35 percent of their healthcare delivery costs. Here are some staggering facts from MGMA and McKinsey & Company:

The amounts for insurance deductibles continue to grow each year and there is no end in sight to these increases. With more and more patients opting for high deductible, low premium commercial health insurance policies, and the growing usage from the Affordable Care Act (ACA), providers must seek ways to collect these large deductible amounts at the point of care, using an integrated approach that includes call centers and comprehensive end-to-end revenue cycle management, coupled with compassionate collection training.