The Medicare Shared Savings vs. Pioneer ACOs

By Gregg A. Masters, MPH During the ‘risk download days’, i.e., from health plan to physician groups or networks and institutional health systems or hospital partners, whether via global percent of premium, or budget driven PMPM contracts, some of us used to joke that using healthcare actuarial data to manage forward clinical risk was like …

Health Reform Readiness Infographic

By Gregg A. Masters, MPH We all love infographics, right? This one caught my eye today. Kind of a clever snapshot of the crap shoot we’re in relative to the legal and political uncertainty festering in the US today. The original graphic is courtesy of @HITconsultant via his blog here. Whether this captures the essence …

Florida Blue and US Oncology aka Advanced Medical Specialties JV Oncology ACO

By Gregg A. Masters, MPH Clearly it was just a matter of time, and again the market is driving innovation outside the codified theater of what is, or isn’t, an ACO at least from the point of view of Federal regulation. Regardless of the relative fiscal impact to the Medicare Trust Fund, i.e., where is …

First Round of CMMI Innovation Grants Announced

By Gregg A. Masters, MPH CMS has disclosed the recipients of the innovation grants this morning. Read their profiles below, from ‘Camp Courage to the Regents of the University of California’ representing an eclectic mix of coast-to-coast academic plays, system lead and entrepreneurial initiatives): BETH ISRAEL DEACONESS Project Title: “Preventing avoidable re-hospitalizations: Post-Acute Care Transition Program …

CMS Innovation Center announcement supporting health care innovation

By Gregg A. Masters, MPH Looks like we’ll get the results of the first round of innovation grants funded via the Center for Medicare and Medicaid Innovation. Rumor has it that there will be a 2nd round of grant funding. I assume we’ll minimally hear about round 1 awards, and perhaps more. Detail via CMMI …

‘Patient safety’ a great place to incorporate accountability into process!

By Gregg A. Masters, MPH Patient safety peeps are a vibrant and dynamic community with a compelling voice and powerful message. Spawned in part by the Institute of Medicine’s series including ‘To Err Is Human‘ and ‘Crossing the Quality Chasm: The IOM Health Care Quality Initiative‘, the underbelly of ‘iatrogenic medicine’ was largely placed into the consciousness …

CTE on the Accountable Care Agenda? Junior Seau it’s latest victim?

By Gregg A. Masters, MPH On a day when another athlete dies from self inflicted wounds, and the acronym ‘CTE‘ (chronic traumatic encephalopathy) finds its way into the popular press, while perhaps opening a line of inquiry as to health consequences of repetitive brain injury, we may find the ante in and around the ‘accountable …

Feel for the enforcers: Shades of Maytag Repair Man?

By Vince Kuraitis This post originally appeared at eCare Management Blog. One of the biggest concerns about ACOs has been their potential to enable market consolidation – that by uniting health care providers the ACO gains market clout and ability to charge higher prices. While this is a legitimate concern about ACOs, so far it’s not playing out. …

ACO train has left station SCOTUS decision irrelevant to market innovation?

By Karen M. Cheung Regardless of how the U.S. Supreme Court will rule on the healthcare law, accountable care organizations are moving forward in coordinating patient care, improving quality and cutting costs. With yesterday’s announcement from the Centers for Medicare & Medicaid Services, 27 providers will be embarking on the Medicare Shared Savings Program, effective …

Inside ‘accountable care’, challenges to the ACO

By Gregg A. Masters, MPH We hear considerable chatter on both sides of the ACO or ‘AC/e’ for accountable care focused enterprise absent the organizational drama of fielding an entity per se with the right structural roots or cultural ‘DNA’. Yet, as someone with principal leadership immersion both setting up and managing the ACO ancestry …