The Success of the NY State DSRIP Program
In April 2014, New York Governor Andrew Cuomo announced that New York would be implementing a series of Medicaid reforms through a Delivery System Reform Incentive Payment (DSRIP) program. The DSRIP...
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The Implications of the Stark Law As We Shift to Value-Based Care
The Stark Law was enacted in 1989 to prevent physician self-referral. Self-referral is when a physician refers a patient to a hospital, lab or other entity to which he/she has a financial benefit....
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Referral Management in a Nutshell
Q: What is referral management? A: Referral management is the process of a primary care provider (PCP) referring a patient to a specialty care provider (specialist). There are two routes that a...
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Ride Sharing Has Just Entered Healthcare
Uber recently launched its newest service line called Uber Health. Uber Health is designed to arrange and facilitate rides for patients that do not have access to reliable transportation. The service...
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Surviving CMS “Crackdowns” on Medicare Advantage Plans
A Modern Healthcare article today highlights the importance for MA plans to do a better job of managing their provider networks in terms of maintaining accurate directory information and ensuring...
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Can We Talk?
The last decade has seen the rapid adoption of the electronic medical record (EMR). While a few major EMR software companies have become familiar names, the overall market is very fragmented, with a...
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A Referral is the Building Block of Your Health Care Network
In today’s environment, health care has become increasingly specialized. Primary care physicians (PCPs), once careful to refer patients out in the “gatekeeper” HMO model, have now left these habits...
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