by Gregg Anthony Masters, MPH Some of you may have heard about the whining by UnitedHealthcare’s leadership on a recent earnings call which included the required ‘management’s discussion or operating results and market conditions’ analysis. A BIG WHAAAA! Overfunded since inception and having perfected the art of ‘upcoding‘ (i.e,, severity of illness and intensity of …
Tag Archives: CMMI
Need Another Acronym? Think ‘CHART’ Courtesy of ‘CMMI’
by Gregg A. Masters, MPH In a sea of relentless ‘acronym soup’ that peppers the landscape and too often separates us from the constituency we ostensibly serve (patients) via added layers of dubious complexity to the dysfunctional U.S. healthcare delivery and financing ecosystem, the Centers for Medicare and Medicaid Innovation (CMMI) has added the ‘Community …
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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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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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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 …
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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 …
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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 …
Meet the Next Generation ACO Cohort
by Gregg A. Masters, MPH As announced in ‘Next Generation ACOs: A Deep Dive Series‘ we’re launching a multimedia (blog, internet radio, social media and community tweetchats) programming schedule that will focus on the accountable care industry with specific deep dives into select participants in the cohort admitted by the Center for Medicare and Medicaid Innovation. Written versions …
Webinar: Next Generation ACO Model – Overview and LOI Information
By Gregg A. Masters, MPH Today marks the end to the eight year reign of President Barack Obama and the birth of the Trump Administration tenure. Yet, so much in the health policy and reform domain remains unclear and on the come. Since the passage of the Affordable Care Act (ACA) in March of 2010 the …
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