Vertically integrated delivery system can be a boon or bust depending on the principles driving the process

L. Gordon Moore, MD With permission from the author I post below a long anecdote about a high functioning solo primary care practice looking to link up with a local group.  This is supposed to be the way to a future state in which primary care practices operate as the front lines of vertically integrated …

Hospitals Need To Focus On Culture In Order to Be Able to Survive in an Era of Accountable Care Organizations and Medicaid Reimbursement Rates

Kent Bottles, MD When a health system asked me to facilitate a Board discussion on physician alignment and integration on November 12, 2010, I was already committed to giving a keynote on the future of health care for the American Institute of CPAs in Las Vegas on November 11.Although I usually fly Delta or USAir …

Inaugural Program Scheduled: ACO Watch – A Mid Week Review of the Market

On November 30th, 2010 at 10:00 AM Pacific and 1:00 PM Eastern, ‘ACO Watch’ will launch a weekly round-up of action in the emerging Accountable Care Organization (ACO) ‘tsunami’. As the volume of activity builds in anticipation of the January 2012 ‘go live’ date, we will summarize, vet, and comment on the activities of the …

4 Accountable Care Challenges for CMS

Tony Miller, for HealthLeaders Media The Accountable Care Organization model presents extraordinary opportunities.  It promises to move Medicare and potentially other payers from traditional, volume-driven, inherently inefficient, and counter-productive fee-for-service financing to a value-driven, patient-centric approach to payment and care delivery.  And unlike a multitude of other reform initiatives affecting care delivery and payment, the …

Medicare Program; Request for Information Regarding Accountable Care Organizations and the Medicare Shared Saving Program

Donald M. Berwick Centers for Medicare & Medicaid Services This document is a request for comments regarding certain aspects of the policies and standards that will apply to accountable care organizations (ACOs) participating in the Medicare program under section 3021 or 3022 of the Affordable Care Act. Comment Date: To be assured consideration, comments must …

Hearing on Strengthening Medicare and Medicaid: Taking Steps to Modernize America’s Health Care System

Donald Berwick submitted testimony: To watch the hearing click here. Chairman Baucus, Ranking Member Grassley, and Members of the Committee; thank you for the opportunity to appear before you to discuss ways to strengthen Medicare and Medicaid and modernize America’s health care delivery system. The Affordable Care Act, passed by Congress and signed into law …

California Medical Association Adopts Organizing Principles for Accountable Care Organizations (ACOs)

Francisco Silva Guiding principle – The goal of an accountable care organization (ACO) is to increase access to care, improve the quality of care and ensure the efficient delivery of care. Within an ACO, a physician’s primary ethical and professional obligation is the well-being and safety of the patient. ACO governance – ACOs must be …

‘Fear and Trembling’ at AHIP?

The impending rise of Accountable Care Organizations (ACOs) as market participants, and their apparent autonomy from an ‘institutional partner’ perspective, whether of the clinical or licensing (i.e., payor) variety, is no doubt raising concerns in certain sectors. Clearly the guidance to date, which enables ACO anointing absent a hospital partner is causing some hospital CEOs, and/or their parent systems, …

Extracting the ‘H’ from P/H/O: The Anatomy of One Unwinding

Gregg Masters, MPH Since we now find ourselves at the gateway of resurgent if not soon to be robust exploratory conversations between hospitals, their medical staffs, the broader private medical community and the likely joint venture entities to implement any collaborative vision, this time under the aegis of Accountable Care Organization (ACO)  incentives, I thought …

Creating Accountable Care Organizations: A NEJM Roundtable

Thomas H. Lee, M.D., Lawrence P. Casalino, M.D., Ph.D., Elliott S. Fisher, M.D., M.P.H., and Gail R. Wilensky, Ph.D. N Engl J Med 2010; 363:e23 Introduction Under the Affordable Care Act, Medicare will launch a Shared Savings Program for groups of health care providers that join forces, with or without hospitals or health plans, to …