In the News: October 6-12, 2016

Sg2 is dedicated to helping our clients interpret the latest news and trends in health care. Below you’ll find our analysis of this week’s key industry headlines, along with links to related Sg2 resources.

Beyond Sg2: Health Affairs Explores State Regulations’ Varied Effects on Freestanding EDs

The authors of this recent Health Affairs article reviewed the great variation in state policy around freestanding emergency departments, which are gaining traction in several states. The authors recapped the varying regulatory environments from Texas (where 190 freestanding EDs have opened since 2010) to California (where they have effectively been banned).

Growth of freestanding EDs has been uneven across the country. Beyond regulatory considerations, local market needs will greatly influence the evolution and proliferation of this facility type. Read this Sg2 Expert Insight to learn more.

Beyond Sg2: Survey Shows That Employers Are Pursuing Value-Based Care

A recent survey by Willis Towers Watson shows an increasing number of employers pursuing value-based arrangements with their insurers and providers to secure the best health outcomes for their employees at the lowest costs. A significant proportion of employers are considering the quality of care through access to centers of excellence (45%) and high-performance networks (20%).

At Sg2 we have been tracking the shift to value-based care across hundreds of markets nationwide. Read this Sg2 report to learn more about the market-specific shifts from volume to value and a recent Sg2 Expert Insight to delve into the heart of the CMS alternative payment models.

Congress Urges Relaxed Implementation of HOPD Site-Neutral Payment

On October 3rd and 6th, 45 Senators and 261 House Representatives, respectively, sent letters urging CMS to relax its interpretation of the site-neutral payment provisions contained within the Bipartisan Budget Act of 2015. Starting January 1, 2017, some off-campus hospital outpatient departments (HOPDs) will no longer receive Medicare facility payments under the Outpatient Prospective Payment System (OPPS). Notably, this law exempts “grandfathered” HOPDs that were billing under the OPPS prior to November 2, 2015, and dedicated emergency departments. Legislators asked CMS to increase exemptions for “grandfathered” HOPDs to include those that expand services, change their address or change ownership. Additionally, they asked CMS to allow regional offices to determine what is considered an “off-campus” HOPD rather than strictly abiding by the 250-yard rule.

Read this recent Sg2 Expert Insight to learn more about the proposed site-neutral payment implementation details.

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As of February 11, 2016, Vizient, Inc. has completed its purchase of MedAssets Sg2 and spend and clinical resource management segments from Pamplona Capital Management, LLC. MedAssets revenue cycle business will continue to operate as a wholly-owned subsidiary of Pamplona Capital Management LLP.

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