e-CareManagement blog

Chronic Disease Management • Technology • Strategy • Issues and Trends

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 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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Trend Spotting: 1) Medicare ACO Dead-in-the-Water, 2) Payers Awaken to ACO Opportunities

It’s time to call it — the Medicare Shared Savings (SS) ACO is dead-in-the-water. Ironically — at the same time — commercial payers are awakening to ACO opportunities. Please read further. Tags: accountable care organizations, ACO, hospital, Medicare

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Aetna, Cigna, Wellpoint Recreating Their Business Models

Major U.S. health insurers, including Aetna Inc., Humana Inc. and WellPoint Inc., are retooling to become more than just health plans, in the wake of the federal health-care overhaul that is changing the rules for the industry’s core business. Diversification plans, touted in meetings with investors this year, include stepped up acquisitions and partnerships that [...]

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BlogTalkRadio Interview — Is Hospital-Physician Alignment Sustainable?

Why have hospitals increasingly been buying physician practices?  Are these marriages based on true love or convenience? Will these marriages survive? To address these questions, let’s take the long view (50–100 years) and revisit 7 assumptions that have driven us to today’s healthcare non-system: Healthcare payment systems have rewarded piecemeal work. Despite uneasiness, hospital-physician relationships have been cooperative. Physicians [...]

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Is Hospital-Physician Integration Sustainable?

Reprinted courtesy of MCOL. Perspectives on a Selected Key Topic |     April 2011/May 2011     |   Volume Three Issue Two Will a material number of hospitals and their core medical staffs, that are relatively independent, evolve into highly integrated delivery systems during this decade, and why? William J DeMarco MA, CMC President and CEO, Pendulum HealthCare [...]

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Tire Kickers Need Not Apply: 8 First Impressions of the Medicare ACO Rule

On March 31, CMS released the long-awaited “Medicare Shared Savings Program: Accountable Care Organizations” document (ACO Rule). Read the details here (strong suggestion: unless you’re working on your PhD in ACOs, start with the fact sheets). There are many surprises. Here are eight first impressions on this 429 page tome: The bar has been set [...]

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