Monitoring the birth of an industry
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?”
By Gregg A. Masters, MPH I have followed this narrative for quite some time albeit inside the industry contained debate of whether so-called ‘non-profit’ [501(c)3] hospitals or their parent systems (really more aptly characterized as “tax exempt”) actually earn this financial advantage via material ‘returns’ to the communities they serve. As can be expected you …
By Gregg A. Masters, MPH There are parallels worth considering! But first for those who’s event horizons’ don’t reach back to the Healtheon era (mid to late 1990’s) a little history may help with the construction of this narrative. Perhaps the dots are optimally connected by the talented and best selling author Michael Lewis in his book …
Continue reading “Is Evolent Health the ‘New, New’ Healtheon?”
By Gregg A. Masters, MPH Last week witnessed a rather spirited discussion stimulated by a series of tweets from Billionaire owner of the Dallas Mavericks (and anointed judge of entrepreneurial insight on CNBC’s ‘Shark Tank‘) Mark Cuban. What’s perhaps most poignant in this energetic public exchange is it comes at a time when ‘health’, ‘healthcare’ …
Continue reading “Mark (I’m Not a Doctor but So What) Cuban’s Bold Vision or Big Ego?”
By Gregg A. Masters, MPH At one level you have perhaps the most risk savvy and successful operators in the Medicare Advantage space aka ‘CAPG‘ (the California Association of Physician Groups) closely tethered to it’s less geographically constrained though California domiciled partner IHA as in ‘Integrated Healthcare Association’ explicitly advocating for the preservation of the …
By Randall Williams, MD* “The definition of insanity is doing the same thing over and over again and expecting different results.” — Albert Einstein If you want to lead your organization to success with value based care, I’d like to help you avoid the mistake of committing organizational insanity. As I’ve written before, all value …
A/C/O Accountable/Care/Organization According to the Centers for Medicare and Medicaid Services (CMS) an Accountable Care Organization (ACO) is defined as: …groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients. While the goal of such broadly cast and some may say overly …
By Gregg A. Masters, MPH In pursuit of the no longer optional ‘triple aim‘ and as once suggested by industry innovator Richard Merkin, MD the founder and CEO of Heritage Provider Network, the ‘gold’ in the ACA may be the programs and outreach of the CMMI. But we’re not obsessed with acronym’s in healthcare, right? So …
Continue reading “The Medicare Shared (ACO) Savings Program – A Tale of Transition”
by Gregg A. Masters, MPH In contrast to the comprehensive ‘go live’ implementation of ‘RomeyCare’ in the Commonwealth of Massachusetts, the phased (and some would say diluted if not ‘fatally’ compromised) implementation of the Affordable Care Act (ACA) has been muted via a staggered on-boarding schedule of its various component parts and further selectively waived …
Continue reading “Vetting the ACA’s Impact on Health Insurance Operators”
by Gregg A. Masters, MPH Day one of the ACO Alignment Summit kicked off in Alexandria, Virginia with excellent presentations from Diwen Chen, Executive Director, Payment Innovation and Accountable Care, Dignity Health, and Michael Donahue, MBA, Vice President, Network Development and ACO Activities for Eastern Maine Healthcare System (EMHS). Dignity Health a hospital system founded …
acowatch.me 