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 …

Signal to Noise Challenges in ACO Actuarial Data: Who’s ‘At Greater Risk?’

This post originally appeared at HealthHombre. The national health expenditure data released last week showed relatively modest 2011 growth, which promptly provoked a back-and-forth about what the figures truly say and what they portend for holding spending in check going forward.  Amid considerable mental gear gnashing, the data have been assessed in light of such potential cost influencers as lingering recessionary effects, clinical v. administrative drivers, and imminent arrival of the full-bore ACA.  Occupying several nodes along the public-opinion continuum, headlines ranged from “Spending …

ACOs, Oncology and the Future of Better Cancer Care

By Gregg A. Masters, MPH As originally posted at JustOncology. The best business model for oncology care is not yet obvious to me. But it is crystal clear that innovative new models are being hatched before our eyes.. via Oncology Times Since CMS (via HHS) issued the final rule addressing ACO provisions and specifically ‘excluded’ oncologists …

The Anatomy of a Patient Centered Medical Home: the Physiology of an ACO?

By Margalit Gur-Arie Obamacare is here to stay, and with it a host of initiatives small and large, some intended and some not so much so, targeting massive transformation of the health care delivery system. One of those initiatives involves the adoption of the principles of a Patient Centered Medical Home (PCMH) for primary care as formulated …

Yes We Can? No, He [POTUS] Didn’t. Not Tonight.

Note: An Opinion Piece By Gregg A. Masters, MPH If you were not dialed into the first presidential debate tonight, you missed a rather tortured, poorly moderated, POTUS failed series of opportunities to credibly discredit his health reform ‘etch-a-sketch’ opponent. In the post debate punditry, and fact checking, this one is likely to ascend to …

J.D. Kleinke Makes It Perfectly Clear!

By Gregg A. Masters, MPH Amidst the relentless noise, fear mongering, hand wringing and incessant misrepresentation of both the legislative history as well as decades of development of sensible health policy context for competing models of managed competition or healthcare market reform, J.D. Kleinke in a recent New York Times Opinion piece titled ‘The Conservative …

SCOTUS Consideration A ‘Pyrrhic Victory’ Regardless of Ruling

By Gregg A. Masters, MPH Ladies and Gentlemen, start your engines! A P/Y/R/R/H/I/C victory is defined by Wikipedia as: (/ˈpɪrɪk/) is a victory with such a devastating cost to the victor that it carries the implication that another such victory will ultimately cause defeat. An army of professional, neo-professional and outright ‘amateur’, including skin in …

SCOTUS and the ACA: Day 1

By Gregg A. Masters, MPH Perhaps the hearing of the new century thus far? The Supreme Court of the United States takes up the challenges submitted with respect to the Patient Protection and Affordable Care Act. From the social media ‘journalism domain’, two hashtags received the predominant volume of tweets tagged to the event; they …