health care network connected

Interoperability Is Essential for a Direct Contracting Entity to Succeed

CMS’s latest offering provides a significant opportunity for payors and providers, but those that can’t crack interoperability will struggle. On April 1, 2021, the first 53 organizations selected by CMS as Direct Contracting Entities (DCEs) kicked off their initial performance period. The second batch of DCEs will enter the model beginning their performance period in […]

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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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