The Quality Payment Program

by Gregg A. Masters, MPH In our healthcare innovation economy from the private sector to material modifications of public programs including Medicare and Medicaid there is a massive effort to identify and enable sustainable delivery and financing schema to stem the treasury bleeding and inch however incrementally towards ‘universal coverage’. Ideological talking points opposing ‘Obamacare‘ […]

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: As the Puzzle Emerges…

by Gregg A. Masters, MPH As the Trump administration takes form via the nomination of Rep. Tom Price to ‘steward’ (or decimate) the massive bureaucracy of the Department of Health and Human Services (HHS) with Seema Verma nominated as Administrator of the Centers for Medicare and Medicaid Administration (CMS) the structural touch-points to manifest the ‘repeal and replace‘ agenda […]

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 – […]

POTUS: The De Facto Health Wonk-in-Chief of the US?

by Gregg A. Masters, MPH   Love him or hate him President Barack Obama continues to demonstrate depth, insight, tenacity and a firm grip on the state of the U.S. Healthcare ecosystem dysfunction (and remedies) well beyond his formal training as a Constitutional scholar. Now as arguably one of the most legislatively accomplished President’s in […]

MACRA, MIPS and APMs: A Report from CAPG

by Gregg A. Masters, MPH So everyone is talking about value based healthcare. No longer is ‘business as usual‘ even an option on the table as the volume driven FFS zeitgeist continues to lose supporters in health policy circles while a growing body of clinical initiatives from ACOs to a range of variably structured and […]

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 […]