William J. DeMarco on Provider Contracting, ACOs, Value Based Purchasing, and Practice Acquisition

By Gregg A. Masters, MPH Courtesy of Clive Riddle and MCOL aka @M_C_O_L, author, consultant and long term managed care industry verteran reflects on the ACO environment, unbundles and expounds on the range of entrants in the ACO space and reports on the status of the playing field as of the May 2012 data point. …

J.D. Kleinke Makes It Perfectly Clear!

By Gregg A. Masters, MPH Amidst the relentless noise, fear mongering, hand wringing and incessant misrepresentation of both the legislative history as well as decades of development of sensible health policy context for competing models of managed competition or healthcare market reform, J.D. Kleinke in a recent New York Times Opinion piece titled ‘The Conservative …

Physicians, ACOs and Those ‘Boiler Plate’ Participation Agreements: Buyer Beware!

By Jeffrey L. Cohen, Esq. There continues to be terrific interest in accountable care organizations (ACOs), which are of course a financially risk-based model of providing healthcare to patients who choose to enroll in the Medicare Shared Risk Program. ACO organizations are often led by hospitals and hospital systems, though occasionally by physician organizations. One …

I’m Absolutely Bullish on the Future of Healthcare!

By Gregg A. Masters, MPH In the walk and perhaps some instances trot towards forming and launching an ACO you have prominent voices on both sides of the debate. The bearish camp is perhaps best represented by the likes Jeff Goldsmith in ‘Can Accountable-Care Organizations Improve Health Care While Reducing Costs?’ or Virgina Herzlinger in …

Medicare Shared Savings Program & Advance Payment Model Application Process

By Gregg A. Masters, MPH Per recent CMS Provider Call: From a CMS ‘National Provider Call’ on July 31, 2012, this is a walk through of the Medicare Shared Savings Program and Advance Payment Model Application Process. The review includes both an overview, and update specific to the two distinct programs. A Q&A session follows …

ACO Explosion

By Gregg A. Masters, MPH On ‘This Week in Accountable Care‘, Wednesday, September 5th, 2012 at noon Pacific and 3PM Eastern, my special guest is industry veteran William J. DeMarco, President and CEO of Pendulum Health. Active since the roll-out of the HMO Act, and instrumental in the development of marquee names and properties in the managed …

ACO Roundup | August 29th 2012

By Gregg A. Masters, MPH We’ve been somewhat dormant on ‘This Week in Accountable Care‘ during the summer months, but there has been no shortage of announcements with the CMS series of proscribed deadlines, as well as the purely discretionary dates associated with ACO arrangements negotiated and launched in the private aka ‘commercial’ market. Today we …

The ‘Medicaid Expansion’ Map: Where We Stand

By Gregg A. Masters, MPH Courtesy of the good peeps at The Advisory Board, aka @TheAdvisoryBd, the emerging picture of where we are going in terms of the mission critical leg of full ACA implementation, rests to a large degree with the Executive Offices of the respective states. As can be expected, there is a …

More on the RyanCare v. Affordable Care Act ‘Conversation’

By Gregg A. Masters, MPH Well Avik Roy, aka @aviksroy, who describes himself as: a Senior Fellow at the Manhattan Institute. Healthcare policy writer for Forbes & National Review. Romney advisor. Independent healthcare investment analyst. and the Manhattan Institute, which describes itself as: a free market thinktank dedicated to developing/disseminating new ideas that foster greater economic …

‘RyanCare’ v. ‘The Affordable Care Act’: Bring on the Death Panels for Grandma

By Gregg A. Masters, MPH Well the ‘repeal and replace’ health reform war is apparently shifting into overdrive via the selection of Congressman Paul Ryan to join the Romney ticket. This is a content rich conversation with something for everyone as we reconcile ‘ACA-esque’ RomneyCare with the voucher based weapon of mass Medicare destruction aka …