consolidation Archives - Recon Strategy

NEJM Highlights for May 2016: Referral for surgery, and a miscellany of interesting biochemistry

Marc Herant June 2, 2016

Surgical volume and referral for surgery: The impact of surgical volume on outcomes has been well documented, but is it top of mind with physicians referring patients to surgery? Readers of the Journal were polled on a hypothetical scenario whereby a community physician would be referring a patient in need of a major surgical procedure to either a nearby community hospital with a well-respected general surgeon doing approximately 5 of these cases a year versus a tertiary medical center 40 miles away. The great majority of readers chose the option

Ochsner and River Parishes: one type of endgame for managing redundant hospital capacity (updated)

Tory Wolff September 26, 2014

Please see update at end of post. If value-based care broadly delivers on its promise to reduce hospital admissions by providing more timely ambulatory care, a lot of today’s bed capacity will end up redundant and stranded. How can we navigate to a new equilibrium? Recent developments in the New Orleans area (whose population size still has not recovered from Katrina and is potentially therefore a model case of oversupply) may offer some window into future endgames for resolving the supply-demand imbalance. Acquire, unbundle, and selectively shut-down One approach is

Upping in ante in Pittsburgh: the health information exchange arms race

Tory Wolff September 8, 2011

A few weeks ago, UPMC announced an agreement among nine area systems to spend $4M over the next two years to launch a health information exchange called ClinicalConnect. Reportedly, Highmark (and presumably the West Penn Allegheny hospital system it is in the process of purchasing) requested to be a part of the initiative but was refused. Building electronic connections across hospitals – particularly between community systems (such as the non-UPMC participants in ClinicalConnect) and tertiary centers such as the UPMC facilities – helps make transitioning patients easier by making full

The curious absence of payers in public HIEs

Tory Wolff August 12, 2011

Last week, the National eHealth Collaborative published a study of sustainability strategies for 11 leading health information exchanges (actually 12 including the VA). I’ll call these public HIEs to distinguish them from private HIEs – proprietary exchanges among a select group of providers such as an integrated delivery system. Remarkably, payer funding has a relatively small role across the sample: Only 3 report payer funding as an essential part of their current revenue model: Availity (a joint venture among major Blues and Humana), the Rochester RHIO and the Quality Health

ESRX-MHS Part 2: mail facility speculations (…or: Indulging my Inner SWAGer)

Tory Wolff August 1, 2011

Summary ESRX was running at close to maximum capacity at its mail facilities while MHS has room to spare. ESRX is facing a scenario of significantly increased demand as greater mail penetration is achieved in the Wellpoint book and lacked the capacity to meet this demand. Similarly, ESRX would not be able to meet increased demand from reform coverage expansion. By combining, ESRX avoided having to build a new facility and the combined entity appears to have enough capacity to close at least one older mail facility. Given that a

ESRX-MHS Part 1: Last stand of the PBM pure play: observations on the Medco-Express combination

Tory Wolff July 29, 2011

UNH’s decision to take the commercial PBM business in-house did not force MHS into ESRX’s arms: I would argue that it removed the major roadblock to what the companies wanted to do anyway. MHS and ESRX had been talking about a merger off and on for few years (per WSJ reporting) and the logic (laid out below) is compelling but FTC concerns must have kept getting in the way. UNH’s decision doubled the size of its PBM subsidiary in terms of lives (somewhat less in terms of scripts because the

Highmark and West Penn: it’s about mitigating consolidation, not transforming the system

Tory Wolff June 30, 2011

Highmark will invest up to $475M in the West Penn Allegheny Health System, a move characterized as a prelude to purchase. This is no bold move to drive closer integration of information flows and care decisions or align incentives in a transformative vertically integrated model. My take: this is about desperately propping up the last competing provider standing in a highly concentrated hospital market. Highmark’s hand was forced by West Penn’s financial bleed out. But, in response, UPMC has thrown down the gauntlet in a move that will reshape the

Tag: consolidation

Recon takes an analytical look behind select developments in healthcare

NEJM Highlights for May 2016: Referral for surgery, and a miscellany of interesting biochemistry

Ochsner and River Parishes: one type of endgame for managing redundant hospital capacity (updated)

Upping in ante in Pittsburgh: the health information exchange arms race

The curious absence of payers in public HIEs

ESRX-MHS Part 2: mail facility speculations (…or: Indulging my Inner SWAGer)

ESRX-MHS Part 1: Last stand of the PBM pure play: observations on the Medco-Express combination

Highmark and West Penn: it’s about mitigating consolidation, not transforming the system

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