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Health Policy/Reform
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) Â 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 on the Serengeti.
An ACO that wants to contract with Medicare must establish itself as a corporation. The Medicare ACO models have substantial disclosure and reporting requirements. We won’t know […]
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
What are the differences between these routes? I see at least 5 factors at play:
Transaction costs
Timing
Incrementalism
Flexibility
Capital cost
Op Ed: Emanuel NYT Editorial is Irresponsible and Naive
Zeke Emanuel’s editorial in the New York Times — The End of Health Insurance Companies — really got my blood boiling. It’s irresponsible and naive. Former Obama advisor Emanuel “predicts”:
By 2020, the American health insurance industry will be extinct. Insurance companies will be replaced by accountable care organizations — groups of doctors, hospitals and other health care providers who come together to provide the full range of medical care for patients.
Irresponsible
Provoking and demonizing health plans might have had populist appeal and political value in […]
Op-Ed: ACP Doctors, Thank You for Acknowledging a Law of the Universe
Resources are finite. They just are. This is not an opinion, it is a law of the universe.
Yet, for my lifetime, I have been incredibly frustrated by medicine’s cultural and practical lack of acknowledgement of this law.
FINALLY, the American College of Physicians (ACP) got it. Kaiser Health News describes the revelation:
The American College of Physicians hit a nerve when it released an updated ethics manual calling for doctors to provide “parsimonious care” – in other words, “to practice effective and […]
Welcome to the Blogosphere! Voice on Population Health
The Care Continuum Alliance announces a timely new blog: Voice on Population Health.
Tracey Moorhead, President and CEO of the Care Continuum Alliance, writes today’s inaugural post. She persuasively notes the increasing importance of the full continuum of population health interventions – wellness, prevention and other approaches to improving health, reducing disease risk and raising productivity.
Bob Laszewski’s essay on today’s THCB resonated with me: 2012: A Year of Huge Uncertainty in Health Care Policy. In my 30 years in health care, I have […]
Holiday Shopping Guide Edition of the Health Wonk Review
Check out the best of  health care policy punditry on the Wright on Health blog. Brad Wright hosts the latest edition of the Health Wonk Review.
Leavitt ACO Report: Overstating or Understating Accountable Care Activity?
Accountable Care Organizations (ACOs) have been likened to
a unicorn — a fantastic creature that is vested with mythical powers. But no one has actually seen one.
a camel — a horse designed by a committee, one that already has its nose in the tent
With this background, you can begin to appreciate the difficulty of conducting an accurate census of ACO animals in the wilderness. Yet, this is exactly the task undertaken in the excellent Leavitt Partners report measuring ACO activity in the US.
As I […]
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)Â 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 unattractive investments for health plans:
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.
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 will allow the companies to employ doctors directly, deliver health-information technologies, and participate in new hospital-doctor groups known as accountable-care […]