Can someone explain why should a health system largely FFS still would want to invest in preventative care /outcomes?

like
Posting as :
works at
You are currently posting as works at

They won’t always be FFS and need to look towards future

like

Reimbursement will eventually be tied to outcomes. Right now quality scores, incentive payments, and total cost of care reimbursement models are paving the way. FFS=antiquated

like

FFS is supposed to go away at some point, places already have incentives when they tie performance to outcomes so it’s good to start as early to set internal benchmarks and continue to track and do well. Consumers who pick plans and even doctors/facilities can also see if the provider is a top rated provider by outcomes (some plans like BCBS list it on their roster). Esp if the US truly goes the route of Medicare for All/single payer system one day, you will have to perform under value based care standards.

like

All of the above, and to add another element, preventative care helps mitigate the ER visit from a patient who can't afford to pay the bill, even with insurance. Helps reduce risk of writing losses on complex cases in the future.

like

Doctors will actually bill for thing patient needs bc they know they will be based on patient outcome rather than just billing

Incentive structures that support healthcare quality

The foundation is moving from volume to value. Eventually, FFS model of reimbursement will be replaced. Preventative care is a good first step for these hospitals that are predominantly FFS to get better at improving patient outcome and managing risk so that they can eventually move to more robust risk-based arrangements. The more the risk, the more $$ are stake and eventually incentivizing health systems to produce better patient outcomes by keeping them out of the hospital.

Besides what folks have already said about the shift towards value based care instead of FFS, another reason hospitals may invest in preventative care and/or addressing social risks (homelessness, food insecurity) is because some hospitals experience high rates of ED utilization and in many cases these are preventable. Especially because many non profit hospitals end up paying some of these high costs (charity care) if the patient cannot pay for their ED visits (under or uninsured). If they invest more in prevention and addressing SDoH, they can keep their costs down too.

Related Posts

Hi all, I’m a mom of 2 (2.5 years and 9 months). I’ve been with IBM five years as a data scientist and more recently as a product manager. I’m looking for my next role and I’ve been applying to jobs externally for about a month and I’ve only received rejections. I’ve struggled with postpartum depression during the first few months. I’ve been doing a lot better lately but I’m feeling these rejections are starting to get to me. Any PMs out there willing to share any advice or connect with me 1x1?

like

How tough is it to break into a FAANG PM role at mid-level if you have less prestigious experience? I have 10+ YOE in product, but some was at a tiny meh startup that fizzled out, some was in the digital wing of a large old healthcare org, and though my current role is GPM at a “name brand” tech company, it’s on the smaller side. Went to a good-but-not-Ivy school. What qualifications and experience are FAANG companies looking for when hiring mid-level PMs? Can I break in at mid-level from here?

like

More people died of covid under Biden than under Trump.

like

I posted here some months back about my ectopic pregnancies but today, I'm posting to tell you all to hang in there and God will do it for you. (Please don't insult me of you don't believe in God because I strongly do).
In a nut shell, we had baby #1 without trying. Started trying for #2 and over 2 years, I had 4 miscarriages and 2 ectopics. In July, my doc informed me that the only way forward was through IVF. I was tired and confused. I PRAYED! and continued trying. (The rest in the comments.)

likeuplifting

I am an Employee Engagement and Relations Manager for a healthcare clinic, and I’m looking for ideas to boost morale/employee satisfaction on a budget. Does anyone have any ideas? Thanks!

like

Any women working in Commercial Insurance in B.C. (Broker, Underwriting, Account Manager or Management) that work for a company you like or love? I'd love to hear what company and why you like them.

like

Hi all, I am currently serving notice period in SAP. I have one year of experience as a Java backend developer. I need referral in any company urgently as I had to resign because I couldn’t relocate to Bangalore due my mother’s health issues. I am open to work remotely or ready to relocate to delhi ncr. I have knowledge in Java, Springboot, MySQL, Git, Docker etc

like

Just cleared conflicts for a big law firm so I can officially leave my toxic mid-size insurance defense firm. I’m planning to give notice Friday, but should I get the start date first? The recruiter said they’d like me to start 11/15. And I seriously want to give notice soooooo bad. I’m so excited to leave that I literally cannot think straight 😂

like

I’ve only had two Brazilian waxes my entire life, and both times, every single hair follicle turned into a pimple. I want to try again (5 months pregnant so shaving isn’t an option anymore). What prep should I do, and what should I tell the salon to prevent it from happening again?

like

What origination % are insurance defense firms giving to the attorney that brings in the file/client?

like

People who use retinol, what strength do you use, how often and is it serum/cream etc? Have you seen any benefits?

like

How insane is it to work two remote full time jobs? Inflation may is kill me

like

Who has 12-15 year old children at home? Are you thinking about getting them the Covid vaccine ASAP? Holding off? What are your thoughts?

like

How important is WLB for long term health? Do you think working for hours and hours infront of the screen everyday will cause health issues after retirement?

likehelpful

Looking to transition out of Healthcare sales into SaaS and would like to get a position with Salesforce, Gartner or even move into the public sector. Just looking for some guidance and advice on anyone who has done this successfully and if you have any contacts that be helpful to learn from.

Can anyone tell me what the salary range is for Monitor Deloitte senior consultants in the UAE? Also I have a SC offer from PwC healthcare (not strategy &) and currently also interviewing with Monitor so according to you all which of the two is better across WLB, growth, culture, quality? Thanks!

like

Work from home has made me super lazy and not a morning person. When I go to my evening workout classes, I barely have energy. Any tips to increase my energy and make me a morning person!?

like

Current care coordinator and full time nursing student looking for a remote healthcare job that pays well and is flexible for students…any suggestions?

Anyone know how to connect with someone on EY's Smart Health team?

(Heads up, I can't tell who "reacts" to the post, so I welcome any advice in the comments.)

like

Who else is staying off LinkedIn after the insane amount of layoff posts from people. It’s enough to make me depressed and worried. How is everyone doing today. Any advice on trying to stay positive?

like

More Posts

If anyone in Orange County is looking for a new full time nanny, I have a recommendation. Feel free to comment or DM. Maybe I’ll be become a recruiter.

Which books would you recommend to a product counel for tech startup about strategy, management, and leadership?

like

No hike like last year ?!

likesmart

What will be wise decision?
Techmahindra as Technical lead with 24lpa
Capgemini as Manager c2 with 20.5lpa
Deloitte as consultant with 18.15lpa(with variable)
?

like

Anyone in NYC looking for a digital producer? I have lots of video experience as well. (Open to other cities as well) Thanks!

We fought a whole war over if places could do this and the racists lost then too

Post Photo
likefunny

Can get like to unlock the DM please.

Post Photo
likesmart

What clients have had layoffs that you know of?

like

Anyone can opine on HKS MPA-ID? I have MBA admits and want to continue working in ID post-MBA but this school just came up on my radar. I dont have money but just thinking long term if I should invest in applying and going. Dual citizen. Thoughts?

like

Can anyone please case me today?

like

Has anyone gotten a prescription to help them focus when studying? My test anxiety for the CPA is crippling at this point. Only one I passed on the first try was while taking adderall. I have two.....

like

This bowl is a way for high school English teachers to share lesson/unit plans, activities, resources, etc.!

like

Idk where to put this aside from here but: I want to look at grad programs, but my gpa is abysmal. But yet, before I graduated, I was actually interviewed but Google/FB/Microsoft/Amazon for SDE roles.

I always thought of getting a side job but never got around to it. What are some good side hustles
for nurses?

like

Can someone who knows more about the law than me explain why the opinion seemed to focus more on when life begins than plain old autonomy? I read both and they seemed to focus a lot on that point. But one of the better arguments I've seen online is that to take even a dead person's organs they had to consent first. Are these 2 totally separate principles or why would that concept not come into play? Or is needing consent from the dead not a federal thing

like

Best handbag / shoulder bag for work that is both professional and also convenient (e.g. can take work laptop, documents, food containers, water bottle)?

I was contacted by an Amazon recruiter for a remote Sr. Program Manager role. I took and passed the assessment and was moved to the hiring manager round which was scheduled for tomorrow. I got an email tonight saying that the Director of the group decided that the person must be in Seattle. I am in Austin, which is not an option. I’m disappointed! The recruiter will let me know if any remote roles come up but in the mean time, does anyone have any remote Amazon roles that they’d refer me to?

like
like

Our SALT team at Crowe is looking to grow - all levels / locations. DM me if you are interested in learning more.

like

Subletting my apt starting mid Nov (flexible with dates and price). Catalyst Chicago, West Loop, Luxury apts, 2b/2b. Please DM me if you or anyone you know may be interested!

Additional Posts in Healthcare Consultants

Hi guys, got an interview for Optum (OAS) coming up - any advice on interview questions? or anything I should prep for in particular?

like

Healthcare finance courses : has anyone taken a exec education course from ivy that you’d recommend?

like

Working at Cerner Corporation for a little over a year in the Integrated Tech Consulting organization. Realized how underpaid I am vs. others (even new hires), and am looking for an exit opportunity. Any advice or companies that are hiring right now?

like

Does anyone have insight into how strong BCG’s healthcare practice is? Thinking more payer/provider than life sciences or med tech

like

Anyone from McKinsey’s Healthcare practice that would be willing to chat? Not looking for a referral per say, just interested in the work that goes on in the provider space. Many thanks in advance.

likehelpful

Has anyone transitioned from an insurance company (I’m currently with Anthem/Elevance)? I currently work in Medicare/Medicaid quality (I have a BS in Health Education) and wanting to make the switch into a consulting role. Looking for advice and/or leads. Thanks!!

like

Anyone here familiar with Manatt, Phelps & Phillips / Manatt Health Strategies? Would love to chat

like

Anyone here from ZS want to chat about interview process and what to expect?

like

ZS 🐠: I gave the wrong solution in the structured case. But was able to give the right solution after the interviewer redirected me. I guess that signals coach-ability 😅. Do I still have a chance for an offer if the behavioral and unstructured case went well?

like

Curious to know the average raise (% wise) most have earned year over year in healthcare consulting? Ex. No promotion, but strong performance. Thank you in advance!

like

Is it worth returning to school for a 1 yr or part time MBA to get into VC/PE, further my career, and expand my network? I have 6 years of consulting experience (big 4 and boutique) and a MPH from a top program already...

like

Best consulting companies for Healthcare related projects ?

I am new to Deloitte. My background is in agile transformation and product management within provider settings. I have found tech projects, but none within healthcare. Any advice for finding these?

likehelpful

Can anyone review or take a look at my resume?

Over 12 years of experience in Healthcare vía administration, any ideas or suggestions to transitioning over to becoming a consultant?

like

Any tips for getting into consulting right now? I've been in the internal consulting/corporate strategy group at an AMC in the northeast for several years now (since I got an MBA) and am looking to make a shift to an external position.

like

Im in my final year of undergrad and have a final round interview with guidehouse for a rev cycle consultant position on Monday. Can anyone provide insight into the format of the interview?

like

How’s EY’s healthcare practice?

likefunny

Providence Health & Services Anyone looking to exit to industry? I’m a former Big 4 revenue cycle consultant now leading the net revenue valuation and analytics at a large West health system with two current openings. One is in the data shop (SQL, cloud migration, Clarity) and the other is on the analyst side (budget/forecast, variance/trend analysis). Offshore team for the grunt work allows us to focus on value-add, including collaboration with our data scientists on integrating machine learning into our processes. Providence Health & Services

likefunny

Anybody here earn an MBA with healthcare focus? Looking to apply in a few years and want to speak to you about your experience :)

New to Fishbowl?

Download the Fishbowl app to
unlock all discussions on Fishbowl.
That was just a preview…
Sign Up to see all discussions
  • Discover what it’s like to work at companies from real professionals
  • Get candid advice from people in your field in a safe space
  • Chat and network with other professionals in your field
Sign up in seconds to unlock all discussions on Fishbowl.

Already a user?
Login here

Share

Embed this post

Copy and paste embed code on your site

Preview

Download the
Fishbowl app

See what’s happening in your industry
from the palm of your hand.

A phone with Fishbowl app

Send download link to your phone

OR

Scan your QR code to download
Fishbowl app on your mobile

By continuing you agree to Terms of Use and Privacy Policy.

Messaging rates may apply

Download app

Sign up for free to view this conversation on Fishbowl

By continuing you agree to Terms of Use and Privacy Policy

Already have an account? Log in

Sign up for free to continue using Fishbowl

By continuing you agree to Terms of Use(New) and Privacy Policy(New)
Messaging rates may apply

Already have an account? Log in

For account settings, visit Fishbowl on Desktop Browser or

General

Legal