A Fork in the Road: ACOs vs. Direct Practice?

by Gregg A. Masters, MPH In the run up to the passage of the Affordable Care Act (select milestones here), the Senate Finance Committee under the leadership of Chairman Max Baucus presided over a comical volume of amendments proffered by his colleagues on the other side of the isle, see: ‘Senate Democrats Lead Historic Passage …

Is Evolent Health the ‘New, New’ Healtheon?

By Gregg A. Masters, MPH There are parallels worth considering! But first for those who’s event horizons’ don’t reach back to the Healtheon era (mid to late 1990’s) a little history may help with the construction of this narrative. Perhaps the dots are optimally connected by the talented and best selling author Michael Lewis in his book …

An ACO Update via Leavitt Partners

By Gregg A. Masters, MPH Just released is the continuing pulse of the accountable care industry (not just ACOs per se) via the consulting firm branded with the imprimatur of a former Secretary of HHS Michael Leavitt who opines from the Red State of Utah on the progress made by market driven initiatives outlined in …

The ‘NexGen ACO’: CMS Speaks [again]

By Gregg A. Masters, MPH At one level you have perhaps the most risk savvy and successful operators in the Medicare Advantage space aka ‘CAPG‘ (the California Association of Physician Groups) closely tethered to it’s less geographically constrained though California domiciled partner IHA as in ‘Integrated Healthcare Association’ explicitly advocating for the preservation of the …

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 …

Precision Medicine v. Accountable Care: A Faux Choice?

By Gregg A. Masters, MPH Whether you call it personalized medicine or as Eric Topol MD prefer’s ‘individualized medicine’ or even via the possible conflation of the two c/o the President @BarackObama ‘Precision Medicine’s’ initiative (see fact sheet here), it strikes me that we may need an emerging business model glossary to make sure we’re …

The ACO: Seen One? You’ve Seen One…

A/C/O Accountable/Care/Organization According to the Centers for Medicare and Medicaid Services (CMS) an Accountable Care Organization (ACO) is defined as: …groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients. While the goal of such broadly cast and some may say overly …

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 …

The State of Accountable Care: Evidence to Date and Next Steps

by Gregg A. Masters, MPH So I registered for the webcast version of this Brookings event titled: ‘The State of Accountable Care: Evidence to Date and Next Steps‘ which noted at 9AM start time. My assumption was Pacific time, so when I dialed in (really logged onto twitter to monitor the webcast hashtag #ACOfuture), the …