It is a long-standing hypothesis shared by many providers that community-based interventions that improve primary care could lead to overall healthcare savings by preventing (or delaying) the occurren…
Summary
In this working paper, we develop the following thesis. In the not so distant future (a decade or two), medicine will be largely governed by algorithms -- highly deterministic clinical pathway…
Summary
A Portland-based urgent care operator is launching a health plan from scratch
The strategy targets the busy and healthy with the convenience of a retail network providing “store brand care”; …
A new study in JAMA (by McWilliams et al.) looks at the Medicare expenditures of patients seeing providers enrolled in the BCBS of Massachusetts version of the ACO (Alternative Quality Contract or “AQ…
In our last post we introduced two potential scenarios.
"Provider bastions" in which buyers of health care services select upfront the network that they will trust to deliver their care in a coordina…
It seems like every day there’s some news outlining strategic actions that various players are taking or other developments with respect to health reform. Here’s a sample of recent news:
Employer ado…
Summary:
Blue Shield of California (BSC) has committed to keeping profits at 2% of revenues or less (and returning any excess).
The commitment is economically meaningful: $180M of 2010 revenues will…
Summary
Health plan profits will be down dramatically in 2011 due to MLR rules
Providing care management services to providers building out ACOs and medical homes can open new revenue streams outsi…
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