Deconstructing Health Reform: 3 Reasons Medicare and Pioneer ACOs May Not Survive

Given changing reimbursement incentives and collaborative models for physicians and hospitals, Greg Mertz, managing director of Physician Strategies Group, LLC, discusses why the Congressional proposal “Better Care, Lower Cost Act” of 2014 is financially more attractive to providers than ACO models and whether he thinks it will be passed. He also deconstructs CMS’ recently reported financial results for such health reform delivery initiatives as Medicare ACOs, Pioneer ACOs, and the Physician Group Practice demonstration, and weighs in on which, if any, model he considers the most sustainable.

Greg Mertz helped healthcare organizations assess which value-based healthcare delivery model is right for their organization during Physician Alignment: Which Model Is Right for You?, a February 19th, 2014 workshop at 1:30 p.m. Eastern.

Length: 5:58 minutes

Improving Population Health with Embedded Case Managers in an Open, Multi-Payor Community

There’s education, there’s experience, and then there’s the ‘right stuff’ — the indefinable personality traits that earmark an individual as a change agent, collaborator and ambassador of case management, says Annette Watson, senior vice president of community transformation for Taconic IPA (TIPA), of TIPA’s requirements for the RN case managers it hires for its advanced patient-centered medical homes.

Then there are the not insignificant contributions of the RN case manager to accountable and patient-centered care, which Ms. Watson describes in this interview.

While staff-buy-in and communication continue to challenge the embedded case manager model, the participant in CMS Innovation Center’s Comprehensive Primary Care (CPC) initiative says reimbursement for embedded case management is less of an obstacle today than in the past, due to funding-friendly care models and pilots descending from healthcare reform.

Ms. Watson shared how TIPA has successfully embedded case managers in an open, multi-payor community during an October 9, 2013 webinar, Improving Population Health with Embedded Case Managers in an Open, Multi-Payor Community.

Length: 8:36 minutes

The Role of Case Managers in Emerging Care Delivery Models

With ACA reforms underway, the case manager is fast becoming a major player in the patient-centric, quality over volume healthcare mindset, taking on more standardized, collaborative approaches to care coordination and its changing delivery systems. But as crucial as case managers are to the evolving healthcare landscape, they also need to realize that they are, in many ways, the new kids on the block. Embedded case managers in particular need to understand that how they relate to their professional partners is one of the most important keys to their success, explains Teresa Treiger, president of Ascent Care Management. Here she shares her views on this and other aspects of the industry, including the opportunities for home-based care and how case managers can maximize the use of technology to manage patient care plans.

Teresa Treiger provided perspectives on the changing healthcare landscape for case management and care coordination during The Role of Case Managers in Emerging Care Delivery Models, a February 21, 2013 webinar, now available for replay.

Length: 13:06 minutes

Predicting Healthcare Reform’s Biggest Losers and Winners

A forecast of 2010 healthcare trends would not be complete without some prognostication on the fate of healthcare reform. The Healthcare Intelligence Network asked William DeMarco, president and CEO of DeMarco and Associates, and Jim Knutson, risk manager and human resources director, Aircraft Gear Corporation, to predict the winners and losers from the controversial legislation — as well as the delivery date of the much-debated package.

DeMarco and Knutson go beyond crystal-gazing to describe the implications for key healthcare stakeholders in the coming year with a special focus on payment reform in Healthcare Trends & Forecasts in 2010: Performance Expectations for the Healthcare Industry, a new special report from the Healthcare Intelligence Network.

Length: 3:57 minutes