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Archive for the "Collaborative Care Management Networks" category

MCOL Thought Leaders: Implications of Narrow Networks

  ow far will the trend towards narrower health plan networks go – and what are the implications?”     Alexander DomaszewiczPrincipal,Mercer   ACA legislation put many guardrails on health program design – premium cost sharing must be affordable based on percent of pay and cost sharing through design requires at least a 60% value plan. […]

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Universal American: A “Healthy Collaboration”

By Gregg A. Masters, MPH; originally posted at ACO Watch I intended to post updates from Aetna and Cigna next in this series, yet today I received a tweet by Vince Kuraitis, aka @VinceKuraitis, calling attention to Universal American a managed care player I’ve not spent much time on. Yet they present a rather interesting […]

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Good or perfect: Cutting the fastest path forward

Guest post by Patrick Gordon, Director, Colorado Beacon Consortium Early pioneers to Colorado did not have the luxury of waiting for railway or infrastructure to be in place before taming a new frontier. Their vision and determination laid the foundation for the settlers who followed. They used the tools and talents they had to develop an […]

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Employers Perceive that Health Plans Add Value to ACOs

A just released study from Aon Hewitt and Polakoff Boland — 2011 Employer Driven Accountable Care Organizations Survey Report — examines employer attitudes toward ACOs.  The report provides useful insights into an area that hasn’t yet received much attention. A couple tables in particular caught my attention. (click on the graphic to view a larger version) Key findings in […]

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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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Payment Transformation: From Volume to Value

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 […]

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The 100 Year Shift? Introduction and Overview

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 […]

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List of Top 10 Health Plan Issues — Out of Whack!

Healthcare IT News just published its list of top issues for health plans in 2011: 1. Administrative Mandates (Compliance HIPAA 5010, ICD-10, etc.). 2. Care Management, Data Analytics, and Informatics. 3. Health Insurance Exchanges and Individual Markets. 4. New Provider Payment & Delivery Systems (ACOs, PCMHs, etc.). 5. Bend the Cost Trend. 6. Medicare and […]

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