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

3 Key Benefits to Prudent Sharing of Physician Performance Data

There are three key benefits to prudent sharing of performance data among physicians, notes Cynthia Kilroy, senior vice president of provider strategy and business development at Optum, who suggests a four-step systematic approach for data dissemination that moves companies away from simply creating “metrics in a box.” Besides the electronic health record, she recommends three other data sources to mine for provider performance metrics.

Cynthia Kilroy explored the key structure, issues and challenges in these evolving reimbursement models during a January 29, 2014 webinar, Accountable Care Reimbursement Models: Moving from Productivity to Population-Based Incentives, a 45-minute program sponsored by The Healthcare Intelligence Network.


Length: 6:04 minutes

Medical Home Neighborhoods: Uplinking Specialists To Create Integrated Systems of Care

If payment inequities can be addressed, communication and technology tools in place in large physician multispecialty groups make them ideal candidates for a medical neighborhood, suggests Terry McGeeney, MD, MBA, director of BDC Advisors. Dr. McGeeney, who spent 13 years of his practice career in a large multispecialty group, has also seen some FQHCs and managed Medicaid programs that do a good job of linking community and social supports required in medical neighborhoods.

As for engaging patients in this emerging integrated care delivery system, try explaining the medical neighborhood’s value proposition for them, he suggests. Patients already get why the integrated approach is good for physicians and insurance companies but need to hear why they should buy in to team care, patient portals and other aspects of centralized care coordination.

Dr. McGeeney shared his expertise in developing medical home neighborhoods during a November 20, 2013 webinar, Medical Home Neighborhoods: Uplinking Specialists To Create Integrated Systems of Care.


Length: 6:16 minutes