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 …

‘Pioneers Take Arrows While Settlers’ Get the Land?’

At the ACO Summit in Washington DC in June 2012 Elliott Fisher, MD arguably one of the admitted father’s of the ACO movement opined perhaps prophetically from a panel including Mark McClellan, MD and former Health Affairs Editor, now RWJF Senior Health Policy Advisor Susan Dentzer the above wisdom. Today, CMS via the Center for Medicare …

Back to the Future: Another Run for PPMC’s v2.0?

By Gregg A. Masters, MPH This is about as good a framing of the failed run during the 1990s when the physician practice management (PPMC) industry caught the attention of Wall Street and had a 10 year run before a literal collapse of what many considered a ponzi scheme at heart. Bottom line is Wall …

The 9 C’s of Accountable Care with Tom Doerr, MD

By Gregg A. Masters, MPH Recently I came across a blog post titled ‘The Nine C’s of Successful Accountable Primary Care Delivery’ by Tom Doerr, MD. I had the additional opportunity to participate in a portion of The Collaborative Payer Model: 5 Lessons for Accountable Care webinar which Dr. Doerr led wherein he unbundled some …

Strategic Market Tea Leaves: The Health Plan Perspective

By Gregg A. Masters, MPH Whether you love em (anyone love their health insurance company?) or hate em, major health plans are in a reasonable position to lead if not steward the needed healthcare transformation. While physicians aka ‘disorganized medicine’ too often circle the wagons and shoot in, and whereas hospital systems present too much …

And the Circle Grows! CMS Announces Another Round of ACOs

By Gregg A. Masters, MPH Industry watchers have to be impressed by the announcement from CMS today that effectively doubles the ACO count from prior reported totals. Is it just me, or can you can sense the subtle shift in market sentiment from skepticism to loss of first mover opportunity in one’s market. For the list of …

The ACO Surprise

By Gregg A. Masters, MPH Timing can be everything at times, no? Just after completing the post: ‘From “Unicorns to Multicorns” ACOs Morphing Below Radar‘, I received information from Oliver Wyman, a Marsh McLennan Company, previewing a study which documents (at least for some) ‘unexpected’ results in the world of ACO penetration. For background market …

From “Unicorns to Multicorns” ACOs Morphing Below Radar

By Gregg A. Masters, MPH This is a continuing long tail series following the content rich and strategy insight generous experiences reported by the ‘risk savvy braintrust’ at the 3rd National ACO Congress aka the ‘walking the talk of innovation’ crowd. From sound-bytes to sensibilities? Via UC Berkeley Professor Steven Shortell, Ph.D., MPH, Professor, School …

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 …

ACOs, ‘HMO lite’ or ‘DNA of the Transformation’?

By Gregg A. Masters, MPH I am regularly amused by some in the popular press as well as guerrilla social media theater (myself included in that bucket) by the continued doubt if not outright dismissal of ACOs as the central spine if not fulfillment DNA of ‘the new, new thing/imperative’, i.e., to manifest the ‘triple aim’ as the sustainable …