Another Milestone Marker in Favor of the ACO Model? Meet Farzad Mostashari, MD

by Gregg A. Masters, MPH


I awoke this morning to an email from a PR rep who supports outbound news for one of the emerging ACO management companies enabling physician led participation in the Medicare Shared Savings Program (MSSP) aka Aledade (@AledadeACO).

I then copy, pasted and tweeted the headline: ‘Aledade Creating New Medicare Accountable Care Organizations in Seven States.

I usually ignore ‘PRs’, yet this announcAledade newsement is material as it lends support via a growing body of evidence on the viability of the ACO model and its enabling ‘consciousness’ if not ‘sentiment shift’ in the prevailing market narrative.

While some still slam the ACA – and by proxy it’s ACO ‘workhorse’ – via relentless yet ‘diminishing returnsimpact of the ‘government takeover‘ fear mongering fueled by strategically sourced oppositional research, there is a building steady body of evidence supporting both the model and the broader context of efficacy of the competitive dynamics the ACA has unleashed on the stewards of our at risk (some say collapsing) healthcare economy.

Ergo my tweet:

Aledade news tweet

Ever since the Senate Finance Committee took up the debate and relentless series of ‘amendments‘ proffered by the ‘Rs’ trying to ‘improve‘ the proposed legislation that eventually emerged as the Patient Protection and Affordable Care Act (I NEVER use the pejorative term ‘Obamacare’), I’ve been a voice in the narrative of trying to get the facts of competitive market dynamics into the post political conversation around reforming our complex healthcare economy.

This is no easy task as the complexity of both the political process and objective reporting of how legislation becomes law including its contextual historical narrative is addressed in ‘A Legislative History of the Affordable Care Act: How Legislative Procedure Shapes Legislative History.

A challenge recognized upfront via admittedly ‘apolitical’ or ideologically agnostic ‘law librarians’ (yeah, you know those agenda driven bullies):

“Using the health care legislation passed in 2010 as a model to show how legislative procedure shapes legislative history, this article posits that legislative procedure has changed, making the traditional model of the legislative process used by law librarians and other researchers insufficient to capture the history of modern legislation. To prove this point, it follows the process through which the health care legislation was created and describes the information resources generated. The article concludes by listing resources that will give law librarians and other researchers a grounding in modern legislative procedure and help them navigate the difficulties presented by modern lawmaking.”

Since social media was starting to pick up in 2009 – 2010 time-frame, and given the angst associated with the public’s consumption of the ACA, I started ACO Watch and latter the hashtag #healthreform to track tweets associated with ACA consideration.

None-the-less, 5 years later the disinformation campaign persists though some of the pieces of the ACA are starting to show some promise of the law’s original intent. ACOs often referred to as a flawed model, perhaps an ACO lite if you will or too little too late to make a difference, the emerging datasets (both government and private market tea leaves) are building a case that the law is working.

Tomorrow on PopHealth Week, join my colleague, co-host and co-founder Fred Goldstein as we chat with Aledade Founder and CEO Farzard Mostashari, MD. This month we’re conducting a series on Population Health and ACOs talking to leadership from each ACO type: physician led, hospital sponsored and health plan enabled.

Listen here! We’re live 12 Noon Pacific/3 PM Eastern, and on demand thereafter.

Original posted on ACOwatch.com.

Population Health and ACOs: A Deep Dive Into Model Type and Results To Date

by Gregg A. Masters

As we continue our journey into population health and it’s relationship to and ACO Watch @ACOwatch @ACOalliancesynergies with all forms of innovation enabling the broad brush outcomes of the ‘triple aim’, better health outcomes, improved user experience and lower per capita costs, we shift our focus to the accountable care industry and ACOs in particular.

The month of August we’ll chat with executives from each of the following types of ACOs: physician led, hospital sponsored and health plan enabled.

On the first broadcast at 12 Noon Pacific/3PM Eastern we’ll provide an overview of the space and touch on the history and origins of ACOs, the motivations of the Affordable Care Act (ACA), then pivot to the pros and cons of the various models in the market and to the extent we can compare and contrast results, we’ll offer up data posted to the public domain.

Join Fred Goldstein @fsgoldstein and Gregg Masters @2healthguru for this exploration into an timely and relevant topic.

 

 

PopHealth Week Explores Full Risk Medicare Advantage with Roy Hinman MD, Founder of Island Doctors, a Pioneering Primary Care Physician

by Fred Goldstein and Gregg Masters

On the Wednesday July 1st, 2015 broadcast at 9 AM Pacific and 12 Noon Eastern PopHealth Week pivots to a progressive physician operation in North Florida innovating via Medicare Advantage risk arrangements with major health plans, including Humana.

PopHealth Week’s guest on July 1 is Roy Hinman, MD the founder and CEO of Island Doctors which employs more than 50 people within 14 offices in Florida stretching from Jacksonville to Interlachen and New Smyrna Beach. He opened his first family practice office in 1991 on Anastasia Island in St. Augustine, Florida.PopHealthWeek-logo-TWTTR-sq

Dr. Hinman is a ‘back to basics’ pioneer and began to take full risk Medicare Advantage in 1998. Since then, Dr. Hinman’s practice has grown to approximately 16,000 capitated Medicare Advantage patients in Florida. He anticipates having 20 offices by the end of 2015 to meet the demand. In addition to his owned offices, they also manage a network of 32 affiliated providers.

With innovative programs targeting diabetes, COPD, cholesterol, smoking and weight loss, he understands keeping patients healthy and how to manage capitated contracts.  His comments may surprise you.

phw_hinmanHere’s some of Dr. Hinman’s bio.

Dr. Hinman was raised in Tulsa, Oklahoma. He is a graduate of Oklahoma Military Academy, received his Bachelor’s Degree in Psychology from Tulsa University, and his Master’s Degree in Human Resource Management from Pepperdine University in Malibu, California. He completed medical school at Universidad Technologica de Santiago in Santo Domingo, The Dominican Republic. He served his family practice residency with the University of Florida Medical Program at the University Medical Center in Jacksonville, Florida and worked as an emergency room physician at Bradford County Hospital in Starke, Florida and at Ed Fraser Memorial Hospital in Macclenny, Florida.

Commissioned as a Second Lieutenant in the U.S. Armored Cavalry in 1975 at Oklahoma State University, Colonel Hinman ultimately retired from the U.S. Army Reserve in 2014 as a Medical Corps officer, after 37 years of military duty in the United States, Germany, Korea, Kuwait, Nicaragua, Panama, Saudi Arabia, Ecuador, the Dominican Republic, and Iraq where he served three combat tours. He recently served as the Territorial Surgeon of the U.S. Virgin Islands.

Dr. Hinman is Board-Certified in Family Practice and is a member of the Florida Medical Association, the American Association of Family Practitioners, the Florida Association of Family Practitioners, the St. Johns County Medical Society and the American Academy of Anti-Aging, and has full Family Practice admitting privileges at Flagler Hospital in St. Augustine, Florida where he has been an active staff member since 1991.

So join PopHealth Week’s guest, Dr. Roy Hinman and gain valuable insights into how he has been doing what many have, and or will be trying in the not to distant future, full risk capitation.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Meet Steven Blumberg AtlantiCare Health Solutions

by Fred Goldstein

This week on PopHealth Week oPopHealthWeek-logo-TWTTR-squr special guest is Steven Blumberg, Senior Vice President and Executive Director of AtlantiCare Health Solutions, AtlantiCare’s accountable care organization. A member of AtlantiCare’s executive leadership team, he has responsibility for development of population health models, programing and delivery. Blumberg works with payors and employers to bring value-based purchasing of health services to the marketplace. Blumberg’s more than 25 years of health care leadership experience includes strategic planning, business development, joint ventures, group practice leadership, risk model development and operational integration. He has worked with both large group practices as well as major health systems.

AtlantiCare, located in New Jersey is the region’s largest healthcare organization and largest non-casino employer with more than 5,170 employees and 600 physicians in nearly 70 locations.atlanticare

AtlantiCare Health Solutions is an accountable care organization (ACO). Services offerd through their ACO includes Primary Care Plus, data analytics and information sharing through an EMR, integrated care managers, a hospitalist program and an employee engagement, prevention and wellness program.  The program also offers a patient portal, mobile app and Well4Life, whose mission is to build healthy communities.  So join PopHealth Week as we discuss ACO’s, population health and some of the innovative services offered by AtlantiCare Health Solutions.

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Frederic S. Goldstein is President and Founder Accountable Health, LLC, Past Board Chair, Board of Directors, Population Health Alliance, and co-founder of PopHealth Week.