Monitoring the birth of an industry
by Gregg A. Masters, MPH Beneath the ideological crossfire and mostly bluster of the ACA ‘repeal and replace crowd’, while the latest ‘new, new, thing‘ aka the defacto Rorschach upside of a litany of mostly vaporware or me too ‘meh‘ digital health apps, platforms or S-1 filings (see: ‘Disruptive Idiots from Silicon Valley‘) stumble into maturity amidst …
Continue reading “The Droids You Are Looking For Are Not Here”
by Laura Joszt This week, The American Journal of Managed Care was in Palm Harbor, Florida, hosting the fall live meeting of its ACO and Emerging Healthcare Delivery Coalition, where stakeholders from across the healthcare industry discussed best practices. As the country moves from volume to value, accountable care organizations (ACOs) can play a key role …
by Gregg A. Masters, MPH First there was section 30222 prescribed by the Patient Protection and Affordable Care Act (“ACA”), which added section 1899 to the Social Security Act that requires the Secretary of Health and Human Services to establish the [Medicare] Shared Savings Program (MSSP), see: ‘Summary of Final Rule Provisions for Accountable CareOrganizations under the Medicare …
by Gregg A. Masters, MPH If you’re a health policy junkie like me, then the best show in town (or anywhere for that matter) was in the Dirksen Senate Office Building in Washington, D.C., where HMO industry veteran and Chairman, President and CEO of Aetna Mark T. Bertolini and Anthem President and CEO Joseph R. Swedish among …
Continue reading “Health Insurance Industry Consolidation: Any ‘Qui Tam’ Exposure?”
by Gregg A. Masters, MPH It might have been prescient but minimally it was perfect timing. While Fred Goldstein, President of Accountable Health, LLC, and me were prepping for our session to re-cap on PopHealth Week (@PopHealthWeek) some of the insights from our deep dive series into Population Health and ACOs, reporting insights from embedded executives at physician …
by Gregg A. Masters, MPH I awoke this morning to an email from a PR rep who supports outbound news for one of the emerging ACO management companies enabling physician led participation in the Medicare Shared Savings Program (MSSP) aka Aledade (@AledadeACO). I then copy, pasted and tweeted the headline: ‘Aledade Creating New Medicare Accountable Care …
Continue reading “Another Milestone Marker in Favor of the ACO Model?”
by Gregg A. Masters, MPH Wow! Ahead of the 4th of July weekend Mark T. Bertolini (@mtbert) and Bruce D. Broussard (@BruceDBroussard) both savvy and seasoned managed health care industry players and visionary captains at @Aetna and @Humana respectively, announced their marriage via a $35 billion, see Bloomberg story: ‘Aetna-Humana Deal to Lower Consumer Costs, …
Continue reading “The @Aetna and @Humana Marriage: Will It Be Different This Time?”
By Gregg A. Masters, MPH In the relentless sound byte and laughable misrepresentation of facts proffered by ideologues intent upon diluting if not repealing the ACA, one consistent voice of reason and evidence mindfulness is that presented by the cogent and thoughtful reflections on the indicia of ACA implementation courtesy of ‘team Commonwealth Fund’ aka @CommonWealthFnd. …
Continue reading “The ACA, ACOs and Health System Reform 5 Years Later”
by Gregg A. Masters, MPH I’ve seen this before, and many times at that, see: 6 Reasons Your ACO Will Fail (A Series), Any One Will Do.‘ While some continue to debate and attempt to repeal the Affordable Care Act, the underlying market dynamics on which the vision of ‘Accountable Care‘, the triple aim or …
by Gregg A. Masters, MPH In the run up to the passage of the Affordable Care Act (select milestones here), the Senate Finance Committee under the leadership of Chairman Max Baucus presided over a comical volume of amendments proffered by his colleagues on the other side of the isle, see: ‘Senate Democrats Lead Historic Passage …
Continue reading “A Fork in the Road: ACOs vs. Direct Practice?”
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