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Archive for the "Health Policy/Reform" category

Healthcare Transformation: Coping With the Neutral Zone

I’m being asked the same series of questions a lot lately: Do you think the changes occurring in US healthcare are real?  Are we truly moving away from rewarding volume of care under fee-for-service (FFS) and toward value-based payment and delivery? Are the changes past the point of no return? Will the economic interests of […]

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ACOs: We’re NOT There Yet

by Brian Klepper On The Health Care Blog, veteran analyst Vince Kuraitis reviews a report from the consulting firm Oliver Wyman (OW), arguing that the trend toward reconfiguring health systems to deliver more accountable care is more widespread than any of us suspect. “The healthcare world has only gotten serious about accountable care organizations in […]

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ACOs: Are We “There” Yet?

  A  recent analysis of the ACO market by Oliver Wyman market suggests we’re well on our way toward being “there”. My personal take on this report: Provocative, fresh, thoughtful, well reasoned, expansive — albeit a bit of a stretch However, I suspect many others will describe it as:  Speculative, harebrained, unsupported, overly extrapolative, out-to-lunch, wishful to […]

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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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Hospitals or Health Plans: Who Do You Trust to “Connect” You with Your Health Records?

Over the past decade, I’ve seen a number of studies asking people whom they trust among various health care stakeholders. Nurses, pharmacists, and doctors always come out at the top.  Beyond that: Trust of hospitals tends to be high (60–80%) Trust of health plans is at the bottom of the heap (10–20%) Is this written in […]

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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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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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A 6th Difference Between ACOs and “AC-Like” Arrangements

Last week I wrote about five key differences between formal ACOs (mainly care providers contracting with Medicare)  and informal Accountable Care-Like (AC-Like) arrangements between care providers and commercial health plans. Transaction costs Timing Incrementalism Flexibility Capital cost There’s an important  6th  difference worth noting: Visibility Formal ACOs will be visible from miles away — think elephants […]

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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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