by Gregg A. Masters, MPH It’s been quite some time that I’ve updated this site though not for a lack of news. Yet some 434 posts later following the rollout of the Affordable Care Act, the signature, and against all odds accomplishment of then President Barack Obama, I thought I’d update both subscribers and followers …
Tag Archives: ACA
CMS Announces 2019 Shared Savings Results
by Gregg A. Masters, MPH Some eight plus years in, ACOs are still earning their ‘shared savings‘ industry ‘sea-legs’. While they remain a central actor of transformation from volume to value birthed by the ACA for both the public (Medicare and Medicaid) and private (commercial health plans) sectors, the results are continuing to build. The …
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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 …
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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 …
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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 …
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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 …
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 …
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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 …
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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 …
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