The transition from fee-for-service (“FFS”) to fee-for-value (“FFV”) is a challenging journey for many healthcare organizations, but the stakes are high, and the ability of an organization to navigate the road to success in a FFV world is critical. Though most hospitals and health systems face similar strategic, operational, and financial challenges, the priorities, timing, and approach to preparing an organization for FFV will vary from market to market. This five-part series of webinars, co-presented by The Camden Group, a national healthcare business advisory firm, focuses on “stops” along The Camden Group’s “Roadmap to Fee-for-Value.”  Save the dates, and register for these webinars today!

LOS ANGELES, CA, January 19, 2012 – The Camden Group, a leading national healthcare business advisory firm, continues to expand its expertise in key areas affected by healthcare reform. Joining the executive team are Virginia Tyler, FACHE, Peggy Crabtree, RN, and Marge Mercury, RN, who bring proven track records of success in strategic planning, service line management and managed care.

“Providers and health plans alike are undergoing fundamental change brought on by healthcare reform. Virginia, Peggy and Marge are ideally prepared to help healthcare organizations make the necessary transformations. Drawing on first-hand clinical and management experience at providers and health plans, they provide valuable knowledge and insight to our clients as they work on moving from our current fee-for-service system to the emerging fee-for-value model,” says Steven Valentine, president of The Camden Group.

Now part of The Camden Group’s Rochester office, Tyler previously ran her own consulting firm helping healthcare clients with governance, strategic planning, and mergers. Before moving into consulting, Tyler held multiple simultaneous roles with Thompson Health, including serving as vice president of strategic planning and business development, president of Finger Lakes Community Care Network and executive director of the Finger Lakes Community Care Network Independent Physician Association.

Crabtree, who is joining the Los Angeles office, previously was executive director of cardiovascular and imaging service lines for Huntington Memorial Hospital. Before that, she was South Bay Region service area director for clinical departments and service lines at Providence Health System Little Company of Mary Hospital and chief executive officer of Cardiology Consultants of the South Bay. She began her career as an emergency department nurse before moving into nursing administration.

Another addition to the Rochester office, Mercury headed network and business development for Evercare, a United Healthcare Company, before joining The Camden Group. She also was regional director of medical benefits management for Excellus Blue Cross Blue Shield and vice president of managed care services for the Greater Rochester Independent Physician Association. She began her career as a nurse and nurse manager before moving into case management and then provider relations for health plans.

About The Camden Group

With offices  across the country, The Camden Group is one of the nation’s leading healthcare business advisory firms. The firm provides a broad array of healthcare consulting services in areas ranging from strategic and business planning and financial advisory and compliance, to hospital operations improvement, hospital/physician alignment, clinical integration, bundled payments, and developing accountable care organizations. Since its founding in 1970, The Camden Group has advised more than 1,000 hospitals, medical groups, outpatient facilities, and other healthcare organizations nationwide. For more information, visit us online at www.TheCamdenGroup.com.

Contact:

Sarita Choy, Marketing/Communications Director

The Camden Group

310.320.3990

schoy@thecamdengroup.com

www.thecamdengroup.com

The Camden Group Foresees New Care Models Taking Hold As Healthcare Reform Advances Amid Sluggish Economy

Los Angeles, California, January 5, 2012—The fragile recovery, presidential election year, and expected pivotal Supreme Court decision regarding mandating health insurance coverage will serve as a challenging backdrop this year for healthcare providers as they make more tough decisions about their future and that of the communities they serve. Struggling with rising costs, limited access to capital, and soft patient volumes, hospitals and physicians will increasingly turn to new relationships, mergers, and alliances as they transition to fee-for-value, according to The Camden Group’s annual Top Trends in Healthcare in 2012.

“While these are unsettling times for healthcare, uncertainty cannot be an excuse for paralysis,” says Steven T. Valentine, president of The Camden Group. “The reality is that healthcare reform is locking into place on schedule, and we expect it to continue as presently configured. Preparing to accept and manage financial risk for a defined population is a core competency that providers must develop in the next three years.”

The Camden Group predicts the following top trends:

• Top 3 priorities for hospital CEOs will be cutting costs, driving volume, and hospital-physician alignment.
  • To survive, operating costs must drop by 10 to 20 percent in the next three to five years.
  • The key is capturing greater market share while per capita use-rates continue to slide.
  • With health plans making medical group acquisitions, other medical groups and hospitals will become nervous about potential change in ownership and disruption of referral patterns.
  • Employment is a top choice for physicians intent on mitigating the unknown future of reimbursement, soft volume and development of new care models.
  • Co-management arrangements also will increase.

• The lackluster economy and high unemployment rate will hold down growth but not costs.
  • More people will opt for low premium, high deductible health plans, and both employed and unemployed will defer treatment whenever possible.
  • While most Medicaid payments are flat (or less), Medicare is up less than 2 percent, and many health plans are limiting increases to less than 5 percent. Medical groups and hospitals are coping with wage rates rising 3 percent or more, benefit costs going up 8 to 10 percent, and utility, supplies, and drug costs increasing at least 10 percent.

• Care model changes will accelerate while IT to support the new models consumes attention and capital. 
  • Development of medical homes and bundled payments will increase, and clinical integration will be pursued with or without accountable care organizations.
  • Hospitals will begin to consolidate case management, hospitalists, and intensivists into a centralized, coordinated function.
  • Case management services will be embedded in medical groups and extended to post-acute care. 
  • IT focus will be on meaningful use standards and ICD-10 conversion, with development of HIEs, ambulatory EMR, CPOE, enterprise data warehouses, and results reporting.

• Capital remains king.
  • Access to capital will continue to get tougher for nonprofits while for-profits will see their access increase.
  • Non-profits will boost fundraising efforts while lack of access forces independents to weigh their ability to go it alone.
  • Private equity and public companies will leverage their access to capital to expand their reach into healthcare. 
  • Health plans, with their huge cash reserves, also will invest in managed care capabilities and acquire physician provider groups. 

• The stronger get stronger while the weak merge…or else.
  • Struggling facilities and medical groups will continue to see markets consolidate as volume concentrates to the leaders.
  • With healthcare reform, as many as 1 in every 20 acute-care hospitals could close by 2020.
  • Also by 2020, most states will have a handful of large systems, with very few true independent hospitals without some type of alliance.

• C-suites will see higher turnover.
  • With all of the change due to healthcare reform, delivery models, inadequate payment, labor strife, and declining inpatient volume, new leaders will emerge.
  • C-suites will restructure and reduce management ranks.

About The Camden Group

With offices in Los Angeles, Chicago, New York, and Boston, The Camden Group is one of the nation’s leading healthcare business advisory firms. The firm provides a broad array of healthcare consulting services in areas ranging from strategic and business planning and financial advisory and compliance, to hospital operations improvement, hospital/physician alignment, clinical integration, bundled payments, and developing accountable care organizations.  Since its founding in 1970, The Camden Group has advised more than 1,000 hospitals, medical groups, outpatient facilities, and other healthcare organizations nationwide. For more information, visit us online at www.TheCamdenGroup.com.

Contact:

Sarita Choy, Marketing/Communications Director

The Camden Group

310.320.3990

schoy@thecamdengroup.com

www.thecamdengroup.com