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 […]

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 […]

12 Steps to the Triple Aim or Value Based Healthcare

by Gregg A. Masters, MPH It has been challenging at times being in the ‘innovation conversation’ dating back to the 70s (who remembers ‘WIN’ [whip inflation now], PSROs or even HSAs (no, not the privatization funding mechanism, but the CON overlords) watching what get’s reported by industry press or online media as ‘innovation‘ or ‘bold […]

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 […]

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 […]

Value Based Care: what we can learn from those who succeeded (and failed) in Year 1 of the Medicare Shared Savings Program?

By Randall Williams, MD* “The definition of insanity is doing the same thing over and over again and expecting different results.” — Albert Einstein If you want to lead your organization to success with value based care, I’d like to help you avoid the mistake of committing organizational insanity. As I’ve written before, all value […]

The Medicare Shared (ACO) Savings Program – A Tale of Transition

By Gregg A. Masters, MPH In pursuit of the no longer optional ‘triple aim‘ and as once suggested by industry innovator Richard Merkin, MD the founder and CEO of Heritage Provider Network, the ‘gold’ in the ACA may be the programs and outreach of the CMMI. But we’re not obsessed with acronym’s in healthcare, right? So […]

Vetting the ACA’s Impact on Health Insurance Operators

by Gregg A. Masters, MPH In contrast to the comprehensive ‘go live’ implementation of ‘RomeyCare’ in the Commonwealth of Massachusetts, the phased (and some would say diluted if not ‘fatally’ compromised) implementation of the Affordable Care Act (ACA) has been muted via a staggered on-boarding schedule of its various component parts and further selectively waived […]

Population Health, Social Determinants & the ‘All Hands on Deck’ Race to Matter

by Gregg A. Masters, MPH Population Health Alliance (PHA) Executive Director and current Board Chair Fred Goldstein and I just finished chatting with Rain Henderson, the CEO of the Clinton Health Matters Initiative (CHMI) a project of the Clinton Global Foundation. Rain covered quite a bit of ground from the mission of the Foundation to it’s […]