U.S. Department of Health and Human Services Office of Inspector General: ACOs’ Strategies for Transitioning to Value-Based Care – Lessons From the Medicare Shared Savings Program

by Gregg A. Masters, MPH Many have suggested ACOs would not make a dent in restraining the growth of the U.S. healthcare spend, nor have a meaningful impact on elevating the quality of care provided to covered members or beneficiaries (patients). From ‘HMO-lite‘ criticism to a range of ‘tepid’ to no patient channeling mechanisms, recent …

On Lessons NOT Learned from Managed Healthcare v1.0 and Beyond

by Gregg A. Masters, MPH First in a series of lessons NOT learned tweets to be enhanced and re-posted to @ACOwatch. In the 80s Sanford C. Bernstein analyst Kenneth Abramowitz predicted for-profit hospital systems would dominate the market by 2000. One of the strategy ‘diversification arrows‘ in the quiver of hospital system executives was to enter the …

In Pursuit of the Triple Aim: Can Population Health Management Lead the Way?

By Fred Goldstein, MS and Gregg Masters, MPH Every sector in health care is under pressure to articulate and implement a viable population health initiative that delivers on the triple aim of better health, better quality at a better cost. Despite a significant investment of resources, we have only achieved ‘mixed results’ to date, and …

Blab the Blockchain: Healthcare Implications?

by Gregg A. Masters, MPH Yesterday, April 27th 2016 I joined twitter colleagues and principal co-moderators and my ‘go-to Blab experts James Legan, MD (@jimmie_vanagon) and Charles “Chuck” Webster, MD (@wareflo) for a ‘Blab‘ on ‘blockchain implications in the heathcare space‘ (both delivery and finance). Our featured expert du jour Jeff Brandt was a no-show, so we …

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 …

Courtesy of our friends at AJMC: ‘5 Things to Know About Accountable Care Organizations’

by Laura Joszt This week, The American Journal of Managed Care was in Palm Harbor, Florida, hosting the fall live meeting of its ACO and Emerging Healthcare Delivery Coalition, where stakeholders from across the healthcare industry discussed best practices. As the country moves from volume to value, accountable care organizations (ACOs) can play a key role …

‘Non-Profit IDNs’: Where’s Da Beef?

By Gregg A. Masters, MPH I have followed this narrative for quite some time albeit inside the industry contained debate of whether so-called ‘non-profit’ [501(c)3] hospitals or their parent systems (really more aptly characterized as “tax exempt”) actually earn this financial advantage via material ‘returns’ to the communities they serve. As can be expected you …

Mark (I’m Not a Doctor but So What) Cuban’s Bold Vision or Big Ego?

By Gregg A. Masters, MPH Last week witnessed a rather spirited discussion stimulated by a series of tweets from Billionaire owner of the Dallas Mavericks (and anointed judge of entrepreneurial insight on CNBC’s ‘Shark Tank‘) Mark Cuban. What’s perhaps most poignant in this energetic public exchange is it comes at a time when ‘health’, ‘healthcare’ …

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 …

Meet Redwood Community Care Coalition: A Health Center Nested ACO

By Gregg A. Masters, MPH Wrapped in the ‘population health’ angle but clearly a unique play in the ACO space – at least from the participation point of view of Federally Qualified Health Centers (FQHC), former CEO Steve Ramsland (a 10% allocated FTE) addresses the audience about their market, approach to ACOs and the deployed healthIT …