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Health care delivery is usually discussed in broad, dramatic strokes: open heart surgeries, organ transplants, cancer patient survival rates. But seemingly insignificant things can dramatically impact health care delivery. For example, a patient misses a crucial doctor’s appointment because they lack transportation, leading to another hospital stay. Or, a patient with diabetes lets their health […]

Overview: : Washington State has proposed a Section 1115 Medicaid waiver with the goal to transform the current delivery system for Medicaid providers and beneficiaries. The waiver is a system transformation initiative that will significantly change the way care is delivered to low-income patients. Medicaid patients are entitled to accessible, coordinated and quality health care […]

Not-for-profit hospitals and health systems can achieve a ‘win-win-win’ triple bottom line with community benefit investments that focus on the diverse youth in their communities. Our COPE Health Scholars talent development pipeline programs reach deep into the communities surrounding our partner health systems and provide economic opportunities to the diverse youth in those areas. The […]

“Be careful what you ask for.”   Physicians universally heralded the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) for finally taking down the dangling Sword of Damocles. Yes, the Medicare Sustainable Growth Rate (SGR) is finally, officially gone.   The SGR, an 18-year-old unintended consequence of the Balanced Budget Act of 1997, would […]

A push towards pay-for-performance The term “pay-for-performance” (P4P) has matured in healthcare over the last decade from concept to reality as healthcare policy creators, administrators, and clinical providers work together to develop a more efficient, sustainable, and quality healthcare system focused on the patient. While Medicare demonstration projects and Medicaid Waivers have been around for […]

Developing a caring, diverse and sustainable workforce to support compassionate and high-quality patient care is a critical success factor for today’s hospitals and health systems. In the post-ACA world, the majority of health care payments are transitioning from fee-for-service to value-based payment models, occasioning substantial changes in health care delivery and placing increased emphasis on […]

The nation’s largest health insurance companies are actively courting Congress and the Department of Justice as they attempt to make some large changes in the industry.  Aetna wishes to acquire its smaller rival Humana; Anthem is courting Cigna. UnitedHealth Group, now the largest of the five, is on the sidelines looking at its options.  Centene, which specializes in offering Medicaid coverage, plans to buy Health Net […]

Overview Delivery System Reform Incentive Payment (DSRIP) providers in Texas have been closely following the proposed extension to the Texas State Section 1115 Waiver as the Health and Human Services Commission (HHSC) prepares to submit an extension application to the Centers for Medicaid and Medicare Services (CMS). A main goal of the extension is to […]

As we continue a series examining the implementation efforts for the New York Delivery System Reform Incentive Payment (DSRIP) Program, this piece will focus on the importance of clinical project planning and design for both short and long term clinical transformation and integration milestones. While the current structure of the DSRIP program draws down funds […]

II have been asked why, as a regulatory law attorney, I have taken a detour from that career to provide executive leadership for the COPE Health Scholars programs of COPE Health Solutions. I joined Health Scholars to address the time-worn question, “Where will the next generation of health leadership come from?” How will the best […]