IPA + HIT (aka technology stack) x MSO = ACO

By Gregg A. Masters, MPH For those not familiar with the ever expanding ‘acronym soup’ we often take for granted inside the healthcare borg: I/P/A = Independent Practice Association | H/I/T = Health Information Technology | M/S/O = Management Services Organization Judging by the ‘anemic’ numbers specific to CMS forecasts for participants in the broad …

DC Health Innovation Week: A ‘Triple Aim’ Love In or More Silo’s In the Making?

By Gregg A. Masters, MPH As we trudge forward into various iterations of what and how ‘accountable care’ strategies can be sensibly configured and locally seeded for Medicare, Medicaid as well as commercial markets, attention is often focused on the ‘necessary’ but ‘not sufficient’ contribution(s) from health information technology (HIT). It is rare that a …

Florida Blue and US Oncology aka Advanced Medical Specialties JV Oncology ACO

By Gregg A. Masters, MPH Clearly it was just a matter of time, and again the market is driving innovation outside the codified theater of what is, or isn’t, an ACO at least from the point of view of Federal regulation. Regardless of the relative fiscal impact to the Medicare Trust Fund, i.e., where is …

First Round of CMMI Innovation Grants Announced

By Gregg A. Masters, MPH CMS has disclosed the recipients of the innovation grants this morning. Read their profiles below, from ‘Camp Courage to the Regents of the University of California’ representing an eclectic mix of coast-to-coast academic plays, system lead and entrepreneurial initiatives): BETH ISRAEL DEACONESS Project Title: “Preventing avoidable re-hospitalizations: Post-Acute Care Transition Program …

Feel for the enforcers: Shades of Maytag Repair Man?

By Vince Kuraitis This post originally appeared at eCare Management Blog. One of the biggest concerns about ACOs has been their potential to enable market consolidation – that by uniting health care providers the ACO gains market clout and ability to charge higher prices. While this is a legitimate concern about ACOs, so far it’s not playing out. …

ACO train has left station SCOTUS decision irrelevant to market innovation?

By Karen M. Cheung Regardless of how the U.S. Supreme Court will rule on the healthcare law, accountable care organizations are moving forward in coordinating patient care, improving quality and cutting costs. With yesterday’s announcement from the Centers for Medicare & Medicaid Services, 27 providers will be embarking on the Medicare Shared Savings Program, effective …

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 …

ACOs: A promising report ‘from the front’ via IOM

By Gregg A. Masters, MPH The prevailing sentiment towards ACOs in the market today can be grossly divided somewhere between the skeptic camp perhaps most gently represented by the oft quoted ‘unicorn’ attribution, credited to Mark Smith, MD, MBA, President and CEO of the California Healthcare Foundation: The accountable care organization is like a unicorn, …

ACO Deep Dive Session at this Year’s Health Datapalooza

By Gregg A. Masters, MPH This just in from the Centers for Medicare and Medicaid Innovation and HDI Forum III: The CMS Innovation Center is helping plan one session of this two-day event. An ACO “deep dive” will demonstrate how Accountable Care Organizations can make effective use of claims data through innovative software services and …

Aetna teams with Hoag Orthopedic on bundled payment initiative

By Gregg A. Masters, MPH Leveraging up from the Integrated Healthcare Association’s (IHA) work (and others) in the bundled payment domain, @Aetna announced yesterday that in association with partner health information technology vendor @McKesson_HIT, their work with Hoag Orthopedic Hospital (aka @HoagOrthopedic) in Newport Beach, California. Bundled payment a child of the DRG payment system and long …