Category Archives: Managed Care Contracting

MSSP Contracting Rules Create Operational and Revenue Risk for ACOs

For Health System and ACO Executives | Medicare Shared Savings Program Current as of: July 2026 Executive Takeaway: Current MSSP regulations at 42 C.F.R. § 425.116 make ACO contracting infrastructure an executive-level compliance and revenue issue. CMS requires ACOs to … Continue reading

Posted in Clinical Integration, Compliance Issues, Hospital Issues, Managed Care Contracting, Medical Staff Organization & Structure, Medicare and Medicaid Reimbursement, Physician Issues | Comments Off on MSSP Contracting Rules Create Operational and Revenue Risk for ACOs

Bundled Payment Arrangements for Clinically Integrated Networks

By John Fisher, JD, CHC, CCEP Bundled Payment and ACO Arrangements – Clinically Integrated Payment Methodologies Overview of Bundled Payment Bundled payment represents a significant shift in healthcare reimbursement models, aiming to improve efficiency and quality while controlling costs. Under … Continue reading

Posted in Accountable Care Organizations, Antitrust in Healthcare, Clinical Integration, Managed Care Contracting, Medicare and Medicaid Reimbursement, Reimbursement & Payment Practices, Uncategorized | Tagged , , | Comments Off on Bundled Payment Arrangements for Clinically Integrated Networks

Population Health Management and Clinical Integration

By John Fisher, JD, CHC, CCEP Population Health Management and Clinical Integration June 13, 2016 Population Health Management and Clinical Integration: Structural Foundations of a Reformed Health Care Delivery System Abstract Population health management and clinical integration have emerged as … Continue reading

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