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Archive for the "Care Providers & Care Coordination" category

Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable.

From reading recent headlines, one might easily get the impression that hospitals are resistant — or at least ambivalent — in their pursuit and adoption of accountable care initiatives. Are Hospitals Dragging their Feet on Accountable Care? Commonwealth Fund: “only 13 percent of hospital respondents reported participating in an ACO or planning to participate within [...]

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Physicians Shouldn’t Wait for Big Data: “Small Data” Can Jumpstart Your Care Management Program

by David C. Kibbe MD, MBA and Vince Kuraitis JD, MBA Everywhere we turn these days it seems “Big Data” is being touted as a solution for physicians and physician groups who want to participate in Accountable Care Organizations, (ACOs) and/or accountable care-like contracts with payers. We disagree, and think the accumulated experience about what [...]

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Hospitals…Thinking About Getting Into Health Insurance? 6 Reasons To Lie Down Until the Urge Goes Away.

Greg Masters reports on a recent Kaiser Health News article: Hospitals Look to Become Insurers, As Well as Providers of Care”. This is the dumbest idea I’ve heard since “I’m going to invest all my money in Facebook’s IPO and get rich!” Here are six reasons why: Tags: accountable care, health plaln, hospital

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The ACO Antitrust Police — Nothing to Do

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

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Leavitt ACO Report: Overstating or Understating Accountable Care Activity?

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 [...]

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Six Quick First Impressions of the CMS Bundled Payments for Care Improvement Initiative (BPCII)

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 [...]

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The Practice of Medicine: from Marcus Welby to ???

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 [...]

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Physician-Hospital Relationships: The Hospital Morphs from Revenue Center to Cost Center

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 [...]

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Will Health Plans Continue to Buy Up Hospitals?

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 [...]

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