Surprise Medical Bills In Context: Is Tech the Solution?

By Fred Goldstein, MS and Gregg Masters, MPH It’s only Q1 2020 and everyone is now rightfully preoccupied with the recent World Health Organization (WHO) declaration of the COVID-19 as a global pandemic. Congress, the White House, National Institutes of Health (NIH), the Center for Disease Control (CDC) and local state and county health departments […]

Population Health the 20th Anniversary Edition

By Fred Goldstein, MS, Alexandria Skoufalos, EdD and Gregg Masters, MPH Can you believe it’s been 20 years since the first Population Health Colloquium? Back then, we were just a few months into a new century. Maybe some of you even remember the concern over whether Y2K (a programming shortcut that used two digits to […]

Health Care ‘Texas Style’: A Model for the Nation?

By Gregg A. Masters, MPH This a re-post of an article written in October 2009 following Atul Gawande‘s article in the New Yorker on the ‘cost conundrum‘ which launched his presence and eventual celebrity on the national stage. Gawande was calling attention to the regional variations (small area analysis) in the Medicare spend and associated […]

ACOs and Value Based Care: The Best of Times Or The Worst of Times? It Depends!

By Fred Goldstein, MS and Gregg Masters, MPH This past year has seen major changes to the Medicare Shared Savings Program (MSSP) that launched the huge growth in Accountable Care Organizations (ACOs) a principal workhorse in the transformational copy of the Affordable Care Act (ACA).  It seems that the Center for Medicare and Medicaid Services […]

U.S. Department of Health and Human Services Office of Inspector General: ACOs’ Strategies for Transitioning to Value-Based Care – Lessons From the Medicare Shared Savings Program

by Gregg A. Masters, MPH Many have suggested ACOs would not make a dent in restraining the growth of the U.S. healthcare spend, nor have a meaningful impact on elevating the quality of care provided to covered members or beneficiaries (patients). From ‘HMO-lite‘ criticism to a range of ‘tepid’ to no patient channeling mechanisms, recent […]

APG: Overview of CMMI New Models – Primary Care First and Direct Contracting

by Gregg A. Masters, MPH The future is already here, it’s just unevenly distributed – Attributed to William Gibson As a soldier mainstreaming both HMOs and (‘attorney in fact‘ vs. messenger model) 2nd generation PPOs (that re-priced claims to contract rates) into ‘mainstream medicine‘ in California vs. the then prevailing 2nd or 3rd tier physician/provider […]

Venrock’s 2019 Healthcare Prognosis

by Gregg A. Masters, MPH Received this embargoed report earlier this week. Venrock has formally released the report this morning. One reason I am fond of their work is I’ve been following Bob Kocher, one of Venrock’s principals, since the turbulent introduction of the ACA by the Obama administration. More recently perhaps due to Venrock’s […]

Population Health, Precision Medicine and the Triple Aim

By Fred Goldstein, MS and Gregg Masters, MPH* The field of population health continues to grow and create new areas of exploration and integration.  Population health practitioners are called upon to play a central role as health systems, health plans or healthcare organizations work to implement their strategies designed to improve health care quality, access, […]

On Lessons NOT Learned from Managed Healthcare v1.0 and Beyond

by Gregg A. Masters, MPH First in a series of lessons NOT learned tweets to be enhanced and re-posted to @ACOwatch. In the 80s Sanford C. Bernstein analyst Kenneth Abramowitz predicted for-profit hospital systems would dominate the market by 2000. One of the strategy ‘diversification arrows‘ in the quiver of hospital system executives was to enter the […]

From HMOs and PPOs to ACOs and DPCs: What’s Next?

by Gregg A. Masters, MPH It may come to a surprise for some  that ‘healthcare innovation‘ has been in play for quite some time albeit not fueled by a culture of hacking or disrupting legacy operations principally via technology. Unfortunately a veritable acronym soup of mostly failed initiatives under varying degrees of public, private partnership […]