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Archive for the "Medicare/Care Coordination" category

Medicare Announces 27 ACOs. A New Species?

I’m surprised and intrigued by Medicare’s announcement of 27 new Shared Savings model ACOs. Surprised I had been anticipating this announcement as a defining moment for Medicare’s thrust into accountable care. My expectations had been that we would see either: Boom — a big splash of new Medicare shared savings ACOs announced, including big name [...]

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Will Health Plans Want to Contract with ACOs? Maybe, Maybe Not.

On the Perficient Health IT blog, Christel Kellogg writes: I am hearing that carriers are staying away from ACOs and are not planning on partnering.  What have you heard? This is one of those blip-on-the-radar-screen comments that jarred my attention — and it raises very important questions about industry dynamics. First, let me expand on the issue.  [...]

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What’s the Difference Between ACOs and “AC-Like” Arrangements?

A lot. AC-Like arrangements will be MUCH simpler to create and maintain. The health care market is moving toward accountable care. There are at least two broad paths forward: 1) Formal Accountable Care Organizations (ACOs) by which care providers contract with Medicare 2) Informal Accountable Care-Like (AC-Like) arrangements between care providers and commercial health plans [...]

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HSR Study: Focus on High-Cost Medicare Beneficiaries

Following the Money: Factors Associated with the Cost of Treating High-Cost Medicare Beneficiaries. Health Services Research; February 9, 2011 Access to the full online article is currently available for free on the Center for Studying Health System Change website. Key excerpts: Conclusions. Health reform policies currently envisioned to improve care and lower costs may have small [...]

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MGH Medicare Disease/Care Management Demo Shows Home Run Results!

Medicare has (finally) recently released a report showing home run results for a disease/care management demonstration project! Evaluation of Medicare Care Management for High Cost Beneficiaries (CMHCB) Demonstration: Massachusetts General Hospital and Massachusetts General Physicians Organization (MGH) Remind Me Again About the CMHCB Medicare Demo… The CMHCB started in 2005. My recollection is that the [...]

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Is “CMS Innovation Center” an Oxymoron?

A press release earlier this week announced the new CMS Center for Medicare and Medicaid Innovation. If you went to their Twitter feed today, here’s what you’d see: This struck me as a great pictorial representation of the broader challenges the CMS Innovation Center faces: They’ve kinda sorta figured out there’s a conversation going on out there [...]

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Pilots, Demonstrations & Innovation in the PPACA Healthcare Reform Legislation

Here’s a bit of trivia that will make you the hit of the next cocktail party you attend.  How many times are the words “demonstration” and “pilot” mentioned in the newly passed Federal healthcare reform legislation — the Patient Protection and Affordable Care Act (PPACA)? Answer: “demonstration” — 312 mentions “pilot” — 80 mentions This weekend [...]

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Is Gawande Right? Are Pilot Programs the Key to Delivery System Cost Reductions?

Atul Gawande’s most recent New Yorker article “Testing, Testing” addresses the critics who lament that there is no master plan to curb delivery system costs in pending health reform legislation. Gawande retorts: “Is that a bad thing?” …and he answers his own question by describing the value of pilot programs contained in both the Senate [...]

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Medicare Extends PHR Pilot — Big Mistake!

Medicare announced today that it is extending its Personal Health Record (PHR) pilot project for residents of Utah and Arizona. This is a waste of time and taxpayer dollars. Those of you who read my blog know that I’m a big fan of PHRs, but you have to know when you’re backing the wrong approach. What’s [...]

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