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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Medicaid and SNF

Post-Acute Providers Need to Act Now to Offset Potential Medicaid Cuts

Many healthcare professionals – especially those connected to skilled nursing facilities (SNF) – are extremely worried about the proposed tax plan coming out of the House of Representatives. The House recently passed a $4.1 trillion budget plan that promises deep cuts to social programs, including removing nearly $1 trillion from Medicaid’s budget over the next […]

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