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 […]

Founder and CEO of ACO Management Company Weighs in on Regulatory Uncertainty

by Gregg A. Masters, MPH It’s been a while since my last post. I hope everyone is enjoying their summer. In California we’re dealing with very serious wildfire threat. Please hold space in your thoughts and prayers for all of those in harms way – especially the first responders putting their lives on the line […]

ACOs in the Medicare Shared Savings Program (MSSP): Is There a Fix?

by Gregg A. Masters, MPH The Center for Healthcare Quality and Payment Reform just released ‘How to Fix the Medicare Shared Savings Program‘ with lead author and long term managed health care industry veteran Harold D. Miller, its President and CEO.  Some six (6) years into the Affordable Care Act (ACA) provisions specific to Accountable Care […]

Center for Medicare and Medicaid Services Releases Accountable Care Organization Performance Results

by Gregg A. Masters, MPH Friday, October 27th, the Center for Medicare and Medicaid Services (CMS) released details for participating Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP) for the 2016 performance year.  For reporting ACO results view the entire report here. The National Association of ACOs (NAACOs) weighed in below: The new results […]

ACOs Fudging the Numbers?

by Gregg A. Masters, MPH I came across this piece on the Healthcare Blog penned by Kip Sullivan, Esq, critiquing this article posted in Health Affairs last May ‘Bending The Spending Curve By Altering Care Delivery Patterns: The Role Of Care Management Within A Pioneer ACO‘. Sullivan raises valid points as the the legitimacy of […]

The NextGen ACO: Another Round Opens

by Gregg A. Masters, MPH The Centers for Medicare and Medicaid Innovation has announced the results of its ‘continuous learning‘ commitment model wherein ‘field reports‘ including provider comments and open door inputs are materially incorporated into tweaks of the Medicare Shared Savings Program (MSSP) as risk is progressively adopted by participating ACOs. This ‘new round’ iteration […]

TrumpCare: What We ‘Know’?

by Gregg A. Masters, MPH You’ve no doubt heard the expression: ‘a picture is worth a thousand words‘. Well courtesy of Oliver Wyman Health we have an infographic that segments key provisions of ‘TrumpCare’s‘ impact on providers. For original graphic, click here, and timely commentary, see: ‘Special Election Coverage: What Now? The Impact of a […]

As the TrumpCare Pivots Begins

by Gregg A. Masters, MPH Just when we thought it was safe to get back in the ‘white water of health reform‘ with needed fixes to this arguably complex and ambitious Act, surprise! Against all odds and the best and brightest minds in the polling community welcome President-Elect Donald Trump and his litany of public […]

ACO Winners and Losers: A Quick Take

by Ashish K. Jha Last week, CMS sent out press releases touting over $1 billion in savings from Accountable Care Organizations. Here’s the tweet from Andy Slavitt, the acting Administrator of CMS: Andy Slavitt ✔@ASlavitt NEW ACO RESULTS: physicians are changing care, w better results for patients & are saving money. Over $1B. https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2016-Press-releases-items/2016-08-25.html … 1:32 PM – […]

The Long and Winding Road to Healthcare Price Transparency

by Gregg A. Masters, MPH When Steven Brill published ‘Bitter Pill: Why Medical Bills Are Killing Us‘ in 2013 he brought national attention via a series of personal stories that served to reveal the complex dysfunction inherent in our healthcare delivery and financing system. A veritable ‘conundrum‘ created over the decades of layering managed care […]