Final Medicare Shared Savings Program Rule (CMS-1644-F)

by Gregg A. Masters, MPH Creating consistent high quality original content is hard. At ACO Watch, we’re not in the business of breaking news or high frequency posts to drive eyeballs and traffic to this blog so ‘the numbers’ that might attract advertising or sponsorship (there aren’t any). Instead we (mostly me) watch the developments …

Hey, Remember IPAs, PPOs and TPAs?

by Gregg A. Masters, MPH In a last man standing of sorts in what some may call the legacy and aging infrastructure of the ‘vote with your feet‘ PPO industry including it’s allies in the TPA (Third Party Administrator) space, the American Association of Payors, Administrators and Networks (AAPAN) is holding its 2016 Annual Forum …

Must listen JP Morgan Healthcare Conference Webcasts: @MolinaHealth

by Gregg A. Masters, MPH NOTE: This is the third in a series of ‘Must listen’ webcasts produced at JP Morgan’s 34th Annual Healthcare Conference. The first focused on telehealth sector market leader Teladoc, the second on Centene. For background and details on this august annual gathering, see ‘If It’s January, It’s JP Morgan Healthcare Conference‘. Remaining …

Must listen JP Morgan Healthcare Conference Webcasts: @Centene

by Gregg A. Masters, MPH NOTE: This is second in a series of ‘Must listen’ webcasts produced at JP Morgan’s 34th Annual Healthcare Conference. The first focused on telehealth sector market leader Teladoc. For background and details on this august gathering, see ‘If It’s January, It’s JP Morgan Healthcare Conference‘. Remaining companies to detail as they represent …

CMS Quality Measure Development Plan: A DRAFT

by Gregg A. Masters, MPH An inspirational leader and ‘disruptive‘ politician taken down well ahead of his time once opined: “Ask not what your country can do for you, ask what you can do for your country…” John Fitzgerald Kennedy Fast forward some 55+ years and season such an invitation with the relentless drone of 24/7/365 …

The Droids You Are Looking For Are Not Here

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 …

Courtesy of our friends at AJMC: ‘5 Things to Know About Accountable Care Organizations’

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 …

FLAACO? What’s That?’

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 …

Health Insurance Industry Consolidation: Any ‘Qui Tam’ Exposure?

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 …

ACOs: The Results So Far (It Depends)

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 …