Healthcare Reform Blog

Fresh U.S. healthcare insights from expert analysts on Healthcare Reform, ACOs, Exchanges, Medicaid, Medicare, regional and national trends…and much more
Contributer: Laura Beerman
Topics: ACOs, Pioneer ACOs, Medicare


And another three bite the dust. Following the nine departures from CMS’s Medicare Pioneer ACO program last summer and Sharp HealthCare’s exit in August, Genesys PHO, Franciscan Alliance and Renaissance Health Network have bid adieu to CMS’s brand of accountable care. Predictions are swirling on the program’s demise. But before your local pundit stands on the corner with a sandwich board crying the “The end is nigh,” it’s worth looking at why the Pioneers left and how more departures might be prevented. Read more.
Posted on: 10/2/2014 11:40:16 AM


Bill MelvilleContributor: Bill Melville
Topics: ACOs, Medicare, Texas

Accountable care organizations in Texas were responsible for a large cut of the dollars saved by the Medicare Shared Savings Program thus far. Not all Texas ACOs saved money, but the ones that did indicate that accountable care could have staying power in unexpected places.
Read more.
Posted on: 10/1/2014 3:31:19 PM


Joyce CaruthersContributor: Joyce Caruthers
Topic: Medicaid, Healthcare Reform, Health Insurance Exchanges, Hospital reimbursement

Industry insiders predicted an increase in Medicaid enrollment in states that did not expand Medicaid eligibility under healthcare reform, but so far, that forecast hasn’t panned out.


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Posted on: 9/26/2014 3:46:31 PM


Jane DuboseContributor: Jane Dubose
Topic: ACOs, Pioneer ACOs, Sharp HealthCare

It’s hard even for the most ardent of optimists to find many silver linings in the new data from the federal government on the financial and quality performance of Medicare accountable care organizations. Created by the 2010 Affordable Care Act, the Medicare ACO experiment has been widely seen as one of the most significant shifts in healthcare delivery in the last few decades. Read more.
Posted on: 9/25/2014 1:36:00 PM


Bill MelvilleContributor: Bill Melville
Topics: Healthcare.gov, Nevada Health Link, MNSure, Affordable Care Act

As difficult as the launch of Healthcare.gov was initially, it was a smoother ride than many state-run public health insurance exchanges. Facing mounting costs and uncertainty, state-run exchanges may become a rarity, if not in 2016, then the not-so-distant future.
Read more.
Posted on: 9/18/2014 10:37:42 AM


Deborah WhiteContributor: Deborah White
Topics: CVS/MinuteClinic, Texas Health Resources, Baylor Health Care System, Walgreens’ Healthcare Clinics, Seton Healthcare Family, RediClinic, Rite Aid

Three health systems in Texas have new affiliations with retail drug stores this year as part of a strategic focus on population health management and accountable care organizations.  At first glance, the affiliations may seem odd especially now that retail clinics are offering more primary healthcare services. Wouldn’t the clinics be considered a competitive threat?
Read more.
Posted on: 9/16/2014 4:17:38 PM


Bill MelvilleContributor: Bill Melville
Topics: Mergers/acquisitions, ACOs, Healthcare reform, Health system consolidation, Affordable Care Act

A few months back, Banner Health’s recent expansions into outlying parts of the Phoenix metro area pointed in an intriguing direction: Tucson. Despite the possible stepping stone of purchasing Casa Grande Regional Medical Center between Phoenix and Tucson, it wasn’t clear how Banner would enter the southern Arizona market.
Read more.
Posted on: 9/8/2014 8:57:38 AM


Lyda PhillipsContributor: Paula Wade
Topic: UnitedHealth Group, exchanges, Alabama, Florida, Mississippi, Nevada, Texas

The nation’s largest private insurer, UnitedHealth Group, is jumping into the public insurance exchange market in 2015—heightening competition in at least 15 states in which it plans to compete for individual business.

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Posted on: 9/4/2014 5:17:31 PM


Contributer: Laura Beerman
Topics: ACOs, Centers of Excellence, Atlantic ACO, Optimus Healthcare Partners, UnitedHealthcare, University Hospitals


If you Google “ACO” and “Centers of Excellence,” you get mixed results – which might also be the outcome of combining these approaches to improve healthcare quality and cost efficiency. First, a definition:  Centers of Excellence are generally hyper-focused on the treatment of a particular disease or condition. Examples include bariatric surgery, stroke care and breast cancer care. For these three conditions, there are external organizations that grant formal COE accreditation. But in most cases, a Center of Excellence is a self-dubbed designation used by a hospital or health system to promote a specific service line and team of specialists.
Read more.
Posted on: 9/2/2014 10:34:53 AM


AnnJeanette Colwell

Contributor: AnnJeanette Colwell
Topic: Clinical Integration, Academic medicine, Health system consolidation, Acquisition/mergers

The Cleveland Clinic has national and international clout, including a strong reputation for high quality healthcare. But hospital consolidation in Ohio could challenge the world-renowned system, which is facing intense competition from powerful health systems, two in particular, that have strengthened their integrated delivery networks in recent years and will likely give Cleveland Clinic a run for its money in its home state.

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Posted on: 8/18/2014 3:26:57 PM


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