ACO Onramp: Reading the Pioneer [Exit] Tea Leaves

By Gregg A. Masters, MPH Whenever someone buys a stock for the most part they make a decision that weighs available public (and sometimes ‘non public’) information and concludes that the company’s value exceeds (currently or shortly will) that which is expressed in the bid/offer price points the day the purchase is executed. Yet, there …

We Don’t Need No Stinkin’ Gatekeepers: Oh Really?

Some have suggested that ACOs are a new and improved as in ‘consumer friendly’ version of their managed care predecessors – HMOs. Editor’s Note: For an excellent historical overview on the genesis of the American sick-care industry, check out ‘Health Care Coverage in the United States: A Brief History.‘ As an ‘HMO lite’ derivative of …

Signal to Noise Challenges in ACO Actuarial Data: Who’s ‘At Greater Risk?’

This post originally appeared at HealthHombre. The national health expenditure data released last week showed relatively modest 2011 growth, which promptly provoked a back-and-forth about what the figures truly say and what they portend for holding spending in check going forward.  Amid considerable mental gear gnashing, the data have been assessed in light of such potential cost influencers as lingering recessionary effects, clinical v. administrative drivers, and imminent arrival of the full-bore ACA.  Occupying several nodes along the public-opinion continuum, headlines ranged from “Spending …

A Tale of Two Cities: The Worst of Times or the Best of Times? L.A. v. San Diego

By Gregg A. Masters, MPH Comparing and contrasting healthcare markets or their essential component parts can be a perilous board room exercise if the intent is to make sense of strategy options, that inform enterprise or entity choice, and meaningfully benchmark forward progress. In pursuit of the ‘triple aim’: better experience of care, improved population …

National ACO Patient Engagement Benchmarking Survey

By Gregg A Masters, MPH Earlier today Avado released a National ACO Benchmark Survey directed to select ACO and accountable care industry executives. A core component of ACO success from both a financial and outcomes perspective, and critical to the fulfillment of the triple aim, ‘patient engagement’ is a broadly cast, locally flavored and otherwise …

‘The ACO Must…’ Towards an Operational Definition of ‘Patient Engagement’

By Gregg A. Masters, MPH In the realm of stuff we need to do and sometimes clouded by either ad copy or less than straightforward guru guidance cutting through the clutter can sometimes be confused by the words ‘may’, ‘should’ or other less obligatory statements. For instance: M/U/S/T | a verb |to: be commanded or …

Universal American: A ‘Healthy Collaboration?’

By Gregg A. Masters, MPH I intended to post updates from Aetna and Cigna next in this series, yet today I received a tweet by Vince Kuraitis, aka @VinceKuraitis, calling attention to Universal American a managed care player I’ve not spent much time on. Yet they present a rather interesting profile and operating footprint some …

Strategic Market Tea Leaves: The Health Plan Perspective

By Gregg A. Masters, MPH Whether you love em (anyone love their health insurance company?) or hate em, major health plans are in a reasonable position to lead if not steward the needed healthcare transformation. While physicians aka ‘disorganized medicine’ too often circle the wagons and shoot in, and whereas hospital systems present too much …

JP Morgan Healthcare Conference Unbundled: Something for Everyone?

By Gregg A. Masters, MPH The 31st annual get together of biotech, pharma and an eclectic litany of publically held healthcare company and many impressive tax exempt health system peeps was my first albeit from a somewhat disadvantaged, i.e., ‘crasher’, status. Yet, in the overall program mix there seemed to be something for everybody from …

And the Circle Grows! CMS Announces Another Round of ACOs

By Gregg A. Masters, MPH Industry watchers have to be impressed by the announcement from CMS today that effectively doubles the ACO count from prior reported totals. Is it just me, or can you can sense the subtle shift in market sentiment from skepticism to loss of first mover opportunity in one’s market. For the list of …