Not a standalone program, the ACO integrates within healthcare adding accountability
By George Martin, MD – Senior Medical Director for Health Integrated

This is the third in a three part series on Accountable Care Organizations (ACOs).  We have previously explored the history, drivers and success measures for ACOs.  I would like to share some thoughts about the ACOs successful propagation under the new policy strategy versus under cultural market drivers.

Cultural momentum is always a key obstacle when it comes to changing behaviors – even in the case of new policy implementation.  The health care reform legislation is not only policy but strategy.  This legislation is very complex, so much so that within the government, it has been delegated to various departments, notably HHS and the IRS, for implementation.  They are preparing to create structures and rules for healthcare which include ACOs.  As they implement the legislation, it will have the full weight of the federal government behind the deployment.  There is no doubt that ACOs appear to be a potentially effective vehicle to promote health and reduce costs, and yet they are at risk to fail. (more…)

Not a standalone program, the ACO integrates within healthcare adding accountability
By George Martin, MD – Senior Medical Director for Health Integrated

The Accountable Care Organization (ACO) – what is this model and what does it mean in the context of reforming healthcare?  With the ACO being a part of the alphabet soup of healthcare models over the past thirty years, some may only know of the poor early results which have been achieved.  That said, I wanted to explore one proposed model for ACOs with a focus on accountability as that appears to be the main differentiator. 

If we use Mr. Peabody’s ‘way-back’ machine, we will see that first there was pre-paid health as we discussed with the Kaiser history.  This became the model for many of the revised health plans of the 1980s and 1990s in the form of Managed Care Organizations (MCOs).  The Kaiser model helped to spawn such practices as management contracts, primary care networks, preferred provider organizations, clinics without walls, physician organizations, community health information networks, gain-sharing and physician hospital organizations to name a few.  These have created much of the foundation for ACOs as they have offered improvements to healthcare models.  (more…)

Built on over 70 years of healthcare experience, the ACO may be a critical reform cornerstone
By George Martin, MD – Senior Medical Director for Health Integrated

In the context of healthcare reform, new and innovative programs are critical in the evolution of delivering optimum outcomes while reducing the ever-increasing cost associated with care delivery.  Several weeks ago, we published a post regarding Accountable Care Organizations (ACOs).  It continues to be clear to me that ACOs are going to be an accelerator in the healthcare reform landscape. 

In the next several posts, I want to provide my view and analysis of ACOs and the key role they will play going forward.  In discussing the genesis and subsequent foundational relevance of the ACO, I would like to highlight not only the drivers, financing, implementation and barriers as to why the ACO is so critical, but how we can help to catalyze its adoption to reform our own healthcare systems.  (more…)

The free market is driving healthcare reform with new and innovative alternatives
By George Martin, MD – Senior Medical Director for Health Integrated

Concierge Medicine.

Search Google and see what you find.  A combination of practices soliciting your business, business articles reviewing the subject and other related articles will be listed.   Concierge medicine by definition is a relationship between a primary care physician and a patient in which the patient pays an annual fee, or a retainer, to the physician in addition to their regular insurance premiums.  In exchange for this retainer, the physician offers the patient enhanced care and services which might include same day appointments, no-wait and maybe even a personal cell phone number for your physician.  There are many different names for this service, including ‘membership medicine’ or platinum care to name a few.  (more…)

Although the PCMH is routinely confirmed as a viable reform strategy, there is still resistance to adoption
By George Martin, MD – Senior Medical Director for Health Integrated

By way of introduction, my name is George Martin, MD.  I am the Senior Medical Director for Health Integrated.  I have the pleasure of accepting the responsibility and to have tag teamed with Jay Pomerantz, MD on our Health Executive Leadership Blog.  As one who has spent the past 15 years managing and consulting on the implementation delivery, coordination and payment for healthcare, I am passionate about healthcare reform and see how an increased focus on primary care and being able to address some of the other challenges facing health plans and other stakeholders in the healthcare community will help to improve outcomes while reducing overall cost.  I am excited to be facilitating your communications on these relevant topics. 

As was mentioned last week, one of the sessions in the upcoming Health Integrated Fall Executive Leadership Series Event in Chicago on September 22 – 23, will allow detailed discussion concerning the world of reform and the healthcare landscape. (more…)