Insights

Essentials to Success In The CMS Direct Contracting Entity (DCE) PART 2: Provider Network Optimization

The Direct Contracting Entity program is further proof of the federal government’s commitment to value-based care, but most DCE participants are missing a significant savings opportunity: post-acute care. Introduced in 2019 by the Center for Medicare and Medicaid Innovation (CMMI), the Direct Contracting Entity program (DCE) is building momentum in 2021. With 53 participants already […]

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healthcare building blocks

Path Towards COVID-19 Recovery: Offsetting Healthcare Risk and MLR Penalties

COVID-19 delivered a type of perfect storm filled with disrupted usage patterns and delayed elective surgeries with many opting for post-acute care at home due to fear of infection and facility lockdowns. Lower utilization rates meant that health plans found themselves falling below the medical loss ratio (MLR) limits—even as restrictions are gradually lifted, some […]

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post-acute care doctor looking at healthcare technology, telemedicine and patient analytics

The Future of Post-Acute Care Post-Pandemic. Are We Prepared?

According to a recent study, post-acute care (PAC) patient volumes decreased significantly during the COVID-19 pandemic. The cancellation of elective surgeries and decrease in non-urgent hospital admissions were the biggest drivers for provider loss of revenue.  This was in part spurred on by the CMS guidelines recommending the cancellation or postponement of elective, non-essential procedures […]

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