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 […]

The Evolution of ACOs

by Gregg A. Masters, MPH Recently the accountable care industry’s leading ‘skin in the game‘ PPMC 2.0 aka ‘ACOcor‘ equivalent (think PhyCor, MedPartners, FPA Medical, et al) of our time – though Aledade’s model is anything like the pyramid scheme of the PPMC (physician practice management companies) of the 1990s, reviewed the Center for Medicare and Medicaid […]

National ACO Association Weighs In On Sector Performance

by Gregg A. Masters, MPH Amidst the aggressive assault on the Affordable Care Act (ACA) via an unrelenting but unsuccessful ‘repeal and replace‘ agenda, much conversation and debate in the health reform theater since Donald Trump was elected the 45th President of the United States has witnessed considerable speculation about the probable directional vector(s) of reform. […]

On ACOs and their ‘Stealth’ Upside via @Farzad_MD CEO @AledadeACO

by Gregg A. Masters, MPH For those of you not on twitter and not following the former National Coordinator for HealthIT and now co-founder and CEO of ACO ‘Management Company’ Aledade, Farzad Mostashari, MD, I’m pasting his rich thread on ACOs and the prospects for its near term future as a tool in the healthcare […]

Founder and CEO of ACO Management Company Weighs in on Regulatory Uncertainty

by Gregg A. Masters, MPH It’s been a while since my last post. I hope everyone is enjoying their summer. In California we’re dealing with very serious wildfire threat. Please hold space in your thoughts and prayers for all of those in harms way – especially the first responders putting their lives on the line […]