Sg2 Blog

Medicare’s new Enhancing Oncology Model (EOM) is an important opportunity for oncology practices to participate in a voluntary alternative payment model (APM) designed to increase the value of care for Medicare fee-for-service (FFS) patients undergoing chemotherapy. This five-year model not only builds on the Oncology Care Model (OCM) and offers incentives to manage care while reducing spend...

Editor’s note: Joe Cummings, PhD, Vizient Technology Program Director, authored this post, which was originally published on Sg2’s parent company Vizient Inc’s blog. The COVID-19 pandemic has had a significant effect on our country’s most vulnerable populations, from who gets the SARS-CoV-2 virus to its impact on mental health and access to care. For example, the pandemic ...

Many health care delivery organizations believe fee-for-service (FFS) and value-based care (VBC) economic models are at odds with each other. Many analogies highlight this divergence—with perhaps the most popular being the illustration of an individual with one foot grounded on the dock and the other foot on a boat slowly pulling away. While this visual is powerful, it overstates the necess...

Prioritize where to begin care at home efforts in your organization Care at home is not a new concept to many in the healthcare sector as it has existed in some form for the past 30 years. But the COVID-19 pandemic accelerated the need to deliver care differently, specifically leveraging digital health capabilities and shifting care into the home setting. According to Sg2’s Impact of Change&...

As children's hospitals and providers of complex pediatric care emerge from the pandemic, we have seen familiar challenges and priorities tenaciously reemerge. Chronic inadequacies in pediatric behavioral health service delivery, combined with pandemic-induced disruption and stress, have worsened today's acute pediatric mental health crisis. The rising prevalence and severity of pediatric behavior...

Perhaps one of the hottest topics in healthcare today, Medicare Advantage (MA) is anticipated to have a monumental year in 2023. Not only do Congressional Budget Office (CBO) projections indicate 2023 will be the year MA penetration surpasses the symbolic majority threshold of 50% nationally, but also major regulatory changes are set to be enacted or finalized that will impact both plan sponsors a...

The Centers for Medicare and Medicaid Innovation (CMMI) has opened the application window for the Bundled Payment for Care Improvement Advanced (BPCI-A) program for the third and final time. Through May 31, 2023, provider organizations can submit a non-binding application to participate in the program’s two additional model years. The program extension may be an opportunity to work towards o...

The health care industry is facing economic headwinds: surging inflation, pandemic-driven staffing shortages and rising competition from novel disrupters. About half of all hospitals reported a loss in 2022, according to Kaufman Hall, and the outlook for 2023 isn’t much better. Today’s conditions demand a new business model, one that centers on customers first—not products or s...

As part of Sg2’s value-based care (VBC) analysis and market research, we review the quarterly earnings calls from a subset of publicly traded legacy payers and VBC-focused entrants. The summary is designed to highlight emerging trends and dynamics in these closely related industries, especially as they tie to VBC. The following post draws from recently released earnings call transcripts fro...

This post was originally published on Sg2’s parent company Vizient Inc’s blog. In today’s rapidly expanding direct-to-employer contracting sphere, it is of critical importance that employers understand the entire value equation. Too often, an employer’s focus is solely on a discount off what they are currently spending on a per-unit basis and doesn’t consider the myr...