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Health Policy/Reform
A Dark Horse in ACO Formation: Large Physician Groups
Kudos to the AMGA (American Medical Group Association) for advancing the cause of physician-led accountable care organizations (ACOs)! A few days ago it “convened leadership teams from 22 leading medical groups and organized systems of care at the inaugural meeting of the AMGA ACO Development Collaborative”.
In many communities, hospitals (delivery systems) will be the “natural” organization to lead an ACO. Hospitals bring management expertise, IT, capital, and community relationships to the table as important assets.
Questions about Hospital-Led ACOs
I’ll try to keep an open mind, […]
The Achilles Heel of ACOs? Shared Savings Payment Model Unlikely to Motivate Hospitals
Sometimes you read something and the full impact doesn’t hit you until hours — perhaps days — later. As I was out mountain biking today, the importance of something I ran across yesterday suddenly hit me.
Accountable Care Organizations (ACOs) are today’s cure-du-jour for reforming the health care delivery system. Bob Berensen, MD of the Urban Institute strongly questions whether the shared savings model under current legislation provides enough economic incentive for hospitals to disrupt their existing core business of acute, inpatient care.
The dialogue […]
Status Report: HITPC and Workgroup Activities on HITECH Stages 2 & 3
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OK, let me be the first to admit that today’s “just-the-facts-ma’am” post might be a little dry…but trust me, its really important stuff to know in understanding the process of how the Health IT Policy Committee (HITPC) and its workgroups are approaching formulating recommendations for HITECH Stages 2 and 3.
At this point at least two different workgroups are involved in developing recommendations for HITECH Stages 2 and 3.
A newly formed Quality Measures Workgroup. This group will “produce initial recommendations on […]
Overview: Here Come Stages 2 and 3 of HITECH!
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We’ve spent the past year creating the MU (meaningful use) requirements for Stage 1 of the HITECH act. As shown by the diagram above, Stage 1 focuses on Data Capture and Sharing. Now it’s time to begin to focus on Stage 2 (Advanced Clinical Processes) and Stage 3 (Improved Outcomes).
The current generation of EMRs (electronic medical records) were designed primarily to assist care providers with clinical documentation, billing, and maximizing revenues. They were not designed to enable care coordination and […]
Medicare MAPCP Medical Home Demo: CMS Kicks Sands in the States’ Faces
by Jaan Sidorov, MD and Vince Kuraitis
The Medicare MAPCP (Multi-Payer Advanced Primary Care Practice) demo promised to be Medicare’s Biggest Change in 40 Years…
…but the emerging reality isn’t living up to the promise.
In this post, we’ll discuss:
The Promise
An Overview of the MAPCP Demo
Our Main Takeaway: Emerging Reality Suggests Medicare Will Be a “Difficult” Partner
Conclusion: Think Twice Before Signing Up
1) The Promise
The sandbox metaphor was first used by the National Academy for State Health Policy:
For the 10 or more […]
16 Capabilities Physicians Will Need to Implement New Payment Models
(click on the graphic to download the document)
Depending on the nature of the payment changes which are made, physicians may need to enhance their capabilities in some or all of the following sixteen areas:
Achieving sufficient patient volume to support a new or improved service.
Having sufficient upfront capital to design and implement a new or improved service.
Having the skills/experience to efficiently/effectively implement a new/improved service.
Having the ability to obtain and analyze data on the quality of services.
Having the skills/experience to […]
Is HITECH Working? #7: Where’s Plan B? Congress and ONC need to address major flaws in HITECH.
by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
Pop quiz: Among early-stage companies that are successful, what percentage are successful with the initial business model with which they started (Plan A) vs. a secondary business model (Plan B)?
Harvard Business School Professor Clay Christensen studied this issue. He found that among successful companies, only 7% succeeded with their initial business model, while 93% evolved into a different business model.
So let’s take this finding and reexamine our human nature. In light of these statistics, […]
Is HITECH Working? #6: HITECH and Health Reform Objectives are Synergistic
by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
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….or to be more specific, HITECH is synergistic with payment reform that could come from the recently passed national health care reform legislation — the Patient Protection and Affordable Care Act (PPACA).
We’ll keep this post fairly short and try to avoid many of the more divisive aspects of this topic. The need for healthcare payment reform is well understood on both sides of the aisle:
Realizing the full potential of health IT depends in […]
Is HITECH Working? #5: “Gimme my damn data!” The stage is being set to enable patient-driven disruptive innovation.
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by Dave deBronkart (e-PatientDave), Vince Kuraitis, and David C. Kibbe
So far this series has looked at HITECH participation by hospitals (grumbling but in the game) and physicians (wary, on the sidelines), kudos for ONC’s three major policy points, and how HITECH is already moving the needle on the vendor side. Today we’re going to look at the reason the whole system exists: patients.
It’s possible to look at the patients issue from a moral or ethical perspective, or from a business […]
Is HITECH Working? #4: While most attention has been focused on demand side incentives (will doctors and hospitals buy EHRs?), the supply (vendor) side of HIT is already transforming.
by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
Most of the press coverage and attention to HITECH has been to the “buy” side of the market: The central question here has been: “Will doctors and hospitals buy and use EHR technology?”
Meanwhile — and much more quietly — the sell (vendor) side of the EHR market is already dramatically different than it was a year ago. We observe change occurring at at least three levels:
HITECH […]