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 …

‘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 …

Some Context and Perspective on Standing Up the ACO

By Gregg A. Masters, MPH I am passionate and write a fair amount about health reform, innovation in business models and the pursuit of a ‘sustainable healthcare ecosystem’ as I’ve been intimately involved in serial efforts to restrain the appetite of a change resistant industry that Shannon Brownlee aptly frames in Escape Fire the hard …

Are Institutionally Led ACOs ‘DOA’? I Say Heck Yah!

By Gregg A. Masters, MPH At the end of the [business model and strategic positioning] day, it’s all about the intangible but mission critical ‘C’ word, i.e., culture, and whether two traditionally oppositional styles (physician v. hospital) can mash-up and ‘meaningfully integrate’ (clinically, legally & workflow wise) where previous attempts during the 80s and 90s …

Hospitals Back in Insurance Biz: Good News or Bad News?

By Gregg A. Masters, MPH I awoke this morning to read the following headline: Hospitals Look To Become Insurers, As Well As Providers Of Care To wit, I ‘tweeted’: OK, it’s reallly ‘deja vu’ all over again! ‘Hospitals Look To Become Insurers, As Well As Providers Of Care’ For complete original article, click here. Mind …

How Hospitals Can Test the Waters of Accountable Care

By Gregg A. Masters, MPH Found on the Accountable Care Bulletin. Hospitals considering accountable care strategies have plenty of options to choose from, but deciding where to begin can be confusing. Joseph Damore, Vice President of Engagement and Delivery for Premier, explores how hospitals can test the waters of accountable care, from engaging staff in wellness …

Inside ‘accountable care’, challenges to the ACO

By Gregg A. Masters, MPH We hear considerable chatter on both sides of the ACO or ‘AC/e’ for accountable care focused enterprise absent the organizational drama of fielding an entity per se with the right structural roots or cultural ‘DNA’. Yet, as someone with principal leadership immersion both setting up and managing the ACO ancestry …

FTC v. OSF Healthcare

By Gregg A. Masters, MPH One of the more popular downsides associated with the growth and dispersion of ACOs in provider [primarily of the ‘institutional variety’ aka hospital/health system] consolidation and asset concentration, is the risk of anti-competitive pricing leverage. You know, the ‘my way or the highway’ approach of certain providers with near or actual …

Leavitt Partners: Growth and Dispersion of Accountable Care Organizations

Extract Only: Following the Patient Protection and Affordable Care Act’s emphasis on Accountable Care Organizations (ACOs) and the announcement of the Medicare Shared Savings Program, an increased interest has emerged among providers and payers to create ACOs. To date, little has been published regarding the types and locations of organizations adopting principles of accountable care. …

Physician Hospital Co-Management Arrangements

By Marshall R. Burack, Akerman Senterfitt In recent years, a number of regulatory and economic factors have driven hospitals and physicians to find ways to work together in a more coordinated manner in order to improve the quality and reduce the cost of patient care. Factors causing hospitals and physicians to work together include, among other …