Insights

Most of what I write comes out of the same place: a number moved, and the reports didn’t explain why. These pieces are about where performance actually slips in physician group and hospitalist operations, and what it takes to fix it.

  • The Cash Trap: Is Your Provider Enrollment Holding Revenue Back?

    Three of the largest payers in the country, UnitedHealthcare, Cigna, and Centene, recently committed to CertifyOS’s new national shared credentialing program, designed to cut the duplicate submissions providers face. It’s a real step, and anything that reduces the credentialing and provider enrollment burden is welcome.  But I’m watching it with caution, because we have seen…

  • Let the Physician Just Be a Physician

    Every hour of administrative tasks you take off a clinician’s plate is better care and better economics at the same time. I’ve believed one thing since I started in healthcare operations: reducing physician administrative tasks so the physician can just be a physician. As a former nurse practitioner, I’ve been on the other side of…

  • The Medicare Advantage Quality Bonus Is Getting Harder to Earn. That’s an Operations Problem.

    The bonus pool keeps growing. The share of plans reaching it keeps shrinking. For provider groups in value-based arrangements, the difference comes down to operational execution — and to the plan you partnered with. KFF put out a number recently that’s worth a closer look. Medicare will spend $13.4 billion on Medicare Advantage quality bonuses…

  • Value-Based Care Doesn’t Fail Because Physicians Won’t Change

    Every few months a new report comes out naming the biggest barrier to value-based care. This year’s version lands on the same thing it always does, just said a little more plainly: physician adoption. The finding is that clinicians trained under fee-for-service resist the new workflows, and that change management matters as much as the…

  • Running the Operation from Four Different Scoreboards

    Productivity, staffing, quality and financials each get reviewed in their own meeting, with their own definitions. The expensive problems live in the gaps between them.