reviving phos

Background A large multi-specialty physician group (wholly owned and operated by a four-hospital health system) took a 25-percent upside/downside risk as a percent of premium on 6,000 Medicare Advantage (MA) patients. After realizing losses of over $1 million the first year, they determined tighter alignment with key independent specialist groups was necessary to better manage […]

Payment and insurance reform have driven hospital/physician alignment over the past few years. With hospitals and physicians increasingly being held accountable for each other’s actions, the need for tighter integration has grown. The result: a spike in Physician-Hospital Organization (PHO) activity, with hospitals and health systems reviving PHOs that have languished since the ‘90s or […]