e-CareManagement blog

Chronic Disease Management • Technology • Strategy • Issues and Trends

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 [...]

Continue reading

 

Patient “Leakage”: Rethinking Two Field of Dreams Assumptions About ACOs

A study released last week by the Massachusetts Attorney General contains surprising data to challenge two commonly held ACO (accountable care organization) ”Field of Dreams” assumptions. These assumptions relate to patient ”leakage” — out-of-network patient care and referrals. 1) Hospital administrators assume that tighter physician-hospital integration (e.g., through employment of physicians) will result in ”captive referrals” by physicians back to [...]

Continue reading

 

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

Continue reading

 

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 [...]

Continue reading

 

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 [...]

Continue reading

 

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 [...]

Continue reading

 

ACO Roundtable on blogtalkradio: Friday, April 1

On Friday April 1st, 2011 (yes, ‘April Fools day’) at 4 PM Eastern and 1 PM Pacific ACO Watch: A Mid Week Review will host a special roundtable series on the ‘hot of the press’ Notice of Proposed Rules’ pertaining to the implementation of Accountable Care Organizations. For the published rule, click here. The roundtable team will [...]

Continue reading

 

The New ACO Rule is Here…The New ACO Rule is Here…and more!

429 p. Proposed ACO Rule ACO Fact sheet from HHS Medicare Fact Sheet: What Providers Need to Know HHS press release Don Berwick’s article on ACOs in the NEJM ACO Quality Performance Standards Summary FTC/DOJ Joint Antitrust Statement on ACOs TheHill article “Leaked memo reveals Dem strategy for defending healthcare reg” The leaked memo Tags: [...]

Continue reading

 

The 6th Thing to Watch in the Medicare ACO Regulations

Health care lobbyists and advocates are bracing for six pages of the health care reform law to explode into more than 1,000 pages of federal regulations when the Department of Health and Human Services releases its long-delayed accountable care organization rules this week. Politico What should you be looking for as you snuggle by the [...]

Continue reading