This morning I read a short article by my favorite journalist, Fareed Zakaria (who I have been reading since long before he was a CNN news celebrity). In the article, Zakaria covers and expresses his general agreement with a policy paper published by the Wilson Center proposing a new “National Strategic Narrative” regarding prosperity and security.
All across the country, physicians and hospitals are talking to each other about creating new organizational structures to enable them to work together more effectively. Some are trying to create Accountable Care Organizations (ACOs) or Organized Systems of Care (OSCs) to participate in the Medicare Shared Savings Program or similar programs being launched by commercial
Today I attended a webcast sponsored by the Bipartisan Policy Center, an organization “committed to the art of principled compromise.” The webcast featured Farzad Mostashari, MD, ScM, the newly appointed National Coordinator for Health Information Technology, U.S. Department of Health and Human Services. He was joined in a panel discussion by Senators Tom Daschle (Democrat, South Dakota) and Bob
After much delay, the Federal Government has finally released the following: 427 page “notice of proposed rule-making” from CMS covering Accountable Care Organizations (ACO) and the associated Medicare Shared Savings Program 26 page document regarding the “waiver designs” for the Shared Savings programs and the Innovation Center A short “perspective” piece in the New England
Links to CMS ACO Proposed Rules and Dr. Berwick’s associated NEJM comments Read More »
On March 23, 2011, Trent Haywood, MD, JD, and Keith Kosel, PhD, MBA published the results in the New England Journal of Medicine (NEJM) web site of a financial model of a hypothetical Accountable Care Organization (ACO). This model shows that ACOs are likely to lose money on the Medicare Shared Savings Program called for in
While returning from a vacation to Walt Disney World yesterday, my family and I were in a disorganized crowd at the Orlando International Airport boarding the tram that shuttles travelers between terminal buildings. A man yelled “Can I get a fast pass?” Everyone laughed. Anyone who has been to a Disney park knows that a
“Can I get a Fast Pass?”: Learning from Disney about health care quality Read More »
Atul Gawande is a general surgeon at Brigham and Women’s Hospital in Boston, and is an amazingly compelling writer about health care issues. He has written a series of articles in the New Yorker, blending stories of individual patients and their care providers with a larger scientific and health policy context. Some of the most relevant of
Atul Gawande’s articles in the New Yorker most relevant to ACOs Read More »
What’s the problem? Accountable Care Organizations (ACOs) involve the creation of new entities that are intended to improve quality and efficiency of care. But, experts in economics and anti-trust law worry that ACOs can have the unintended effect of reducing competition among health care providers, creating local monopolies that can drive up prices. In a
ACOs must steer clear of anti-trust issues Read More »
As shown in the following graphic recently published by the Healthcare Intelligence Network, it has become common practice to use “case load” as a metric for the productivity of nurses in case management programs or as a measure of the intensity of a case management intervention. More broadly, case load has been used for these
Why “case load” is not a good metric for case management productivity or intensity Read More »
I went to the huge HIMSS’11 convention in Las Vegas a few weeks ago. When visiting the bewildering number of vendor booths, I focused on a few key questions relevant to the challenges facing physicians and hospitals working to establish successful Accountable Care Organizations (ACOs): 1) What is the current state of clinical data exchange
Why many clinical leaders prefer Registries to EHRs: Actively Structured Information Read More »
