APG: Overview of CMMI New Models – Primary Care First and Direct Contracting

by Gregg A. Masters, MPH The future is already here, it’s just unevenly distributed – Attributed to William Gibson As a soldier mainstreaming both HMOs and (‘attorney in fact‘ vs. messenger model) 2nd generation PPOs (that re-priced claims to contract rates) into ‘mainstream medicine‘ in California vs. the then prevailing 2nd or 3rd tier physician/provider […]

Venrock’s 2019 Healthcare Prognosis

by Gregg A. Masters, MPH Received this embargoed report earlier this week. Venrock has formally released the report this morning. One reason I am fond of their work is I’ve been following Bob Kocher, one of Venrock’s principals, since the turbulent introduction of the ACA by the Obama administration. More recently perhaps due to Venrock’s […]

From HMOs and PPOs to ACOs and DPCs: What’s Next?

by Gregg A. Masters, MPH It may come to a surprise for some  that ‘healthcare innovation‘ has been in play for quite some time albeit not fueled by a culture of hacking or disrupting legacy operations principally via technology. Unfortunately a veritable acronym soup of mostly failed initiatives under varying degrees of public, private partnership […]

The Evolution of ACOs

by Gregg A. Masters, MPH Recently the accountable care industry’s leading ‘skin in the game‘ PPMC 2.0 aka ‘ACOcor‘ equivalent (think PhyCor, MedPartners, FPA Medical, et al) of our time – though Aledade’s model is anything like the pyramid scheme of the PPMC (physician practice management companies) of the 1990s, reviewed the Center for Medicare and Medicaid […]

ACOs in the Medicare Shared Savings Program (MSSP): Is There a Fix?

by Gregg A. Masters, MPH The Center for Healthcare Quality and Payment Reform just released ‘How to Fix the Medicare Shared Savings Program‘ with lead author and long term managed health care industry veteran Harold D. Miller, its President and CEO.  Some six (6) years into the Affordable Care Act (ACA) provisions specific to Accountable Care […]

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 […]

Center for Medicare and Medicaid Services Releases Accountable Care Organization Performance Results

by Gregg A. Masters, MPH Friday, October 27th, the Center for Medicare and Medicaid Services (CMS) released details for participating Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP) for the 2016 performance year.  For reporting ACO results view the entire report here. The National Association of ACOs (NAACOs) weighed in below: The new results […]

What, What? ACOs Not ‘DOA’?

by Gregg A. Masters, MPH When the Affordable Care Act passed in March of 2010 and the law’s many moving parts analyzed by the ecosystem stakeholders including operators, health wonks and patient advocates many weighed in that ACOs were doomed to fail. They were just too ‘tepid’ to make a material contribution to the volume […]

Webinar: Next Generation ACO Model – Overview and LOI Information

By Gregg A. Masters, MPH Today marks the end to the eight year reign of President Barack Obama and the birth of the Trump Administration tenure.  Yet, so much in the health policy and reform domain remains unclear and on the come. Since the passage of the Affordable Care Act (ACA) in March of 2010 the […]

The NextGen ACO: Another Round Opens

by Gregg A. Masters, MPH The Centers for Medicare and Medicaid Innovation has announced the results of its ‘continuous learning‘ commitment model wherein ‘field reports‘ including provider comments and open door inputs are materially incorporated into tweaks of the Medicare Shared Savings Program (MSSP) as risk is progressively adopted by participating ACOs. This ‘new round’ iteration […]