Healthcare is joining the network economy.
Let’s adapt strategy and business models for
success during the upcoming transformation.
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. Why? Tags: ACO, antitrust
Accountable Care Organizations (ACOs) have been likened to a unicorn — a fantastic creature that is vested with mythical powers. But no one has actually seen one. a camel — a horse designed by a committee, one that already has its nose in the tent With this background, you can begin to appreciate the difficulty of [...]
This afternoon CMS announced the Bundled Payments for Care Improvement Initiative (BPCII). For details, start reading here. Here are six quick first impressions: 1. It’s very creative and innovative. CMS has demonstrated out-of-the-box thinking and leaves a lot of room for applicants to propose their own approaches. Expect to have to read the materials 2-3 [...]
by Jaan Sidorov MD, MHSA, FACP and Vince Kuraitis JD, MBA Physicians face great uncertainty. According to a survey conducted by The Physicians Foundation, the great majority of physicians (89%) believe the traditional model of independent private practice is either “on shaky ground” or “is a dinosaur soon to go extinct.” In the face of [...]
by Vince Kuraitis JD, MBA and Jaan Sidorov MD, MHSA, FACP In our introductory posting of this series, we noted that economic incentives previously aligning doctor-hospital interests were changing. This creates the potential for The 100 Year Shift – physicians awakening to possibilities for stronger partnerships with payers than with hospitals. In this post, we [...]
I doubt it. IMHO, the recent acquisition by Highmark Blue Cross Blue Shield of West Penn Allegheny Health System (WPAHS) for $475 M is unique to local market conditions. It was done as a last resort and should not be taken as a signal that health plans are starting a hospital buying binge. Why are hospitals [...]
by Jaan Sidorov MD, MHSA, FACP and Vince Kuraitis JD, MBA In our introductory posting, we suggested that a huge shift is underway in the health care industry. Decades of hospital-physician cooperation are not only eroding, we suggest this trend could accelerate. Instead of a natural clinical and economic affinity with hospitals, we foresee the [...]
by Vince Kuraitis JD, MBA and Jaan Sidorov MD, MHSA, FACP Gazing at the horizon, we foresee the potential for a tectonic realignment among physicians, hospitals and payers. Here’s a quick visual representation: This essay is the first of a seven part series. In this first post we will capsulize our vision of this potential [...]
A study released last week by the Massachusetts Attorney General contains surprising data to challenge two commonly held ACO (accountable care organization) ”Field of Dreams” assumptions. These assumptions relate to patient ”leakage” — out-of-network patient care and referrals. 1) Hospital administrators assume that tighter physician-hospital integration (e.g., through employment of physicians) will result in ”captive referrals” by physicians back to [...]
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