Tag: provider business model

Recon takes an analytical look behind select developments in healthcare

Ambidextrous strategy: PART 1 – Payer and provider strategy for two very different worlds

Nikhil Bhojwani July 17, 2013

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 adopts a tightly limited provider network Customers sign on to private exchange Hospital chain grows through acquisition Insurers boycott state exchange Health systems drop out of ACOs Payer collaborates with provider systems to target Medicaid population All of these represent choices or “bets” that firms are making based on a view of a healthcare world facing clear trends. More

Cleveland Clinic’s bold land grab in care improvement: the Community Health Systems deal

Tory Wolff March 21, 2013

Summary The deal locks in an option for Cleveland Clinic to grow its clinical practice transfer business 4x its current size and much larger than Cleveland Clinic’s peers There will be significant challenges to executing given the wide geographic dispersion, Community Health Systems’s mostly unranked facilities and strategy of using the hospital “channel” to drive change in care practice In the long run, the deal will reinforce Cleveland Clinic’s advantage in Big Data (it will take time to realize this) Community Health Systems faces little competition in many markets, potentially

Risk-taking providers in private exchanges: Medica’s “My Plan” private exchange

Tory Wolff December 4, 2012

At a TEDMED conference a couple years ago, I had to write some sample “ask me” questions on the bottom of my ID badge as conversation starters. One of them was “Ask me why PHIX+ACO=:-)” Given the presentations on 3D tissue printers and technologies to help blind people just about see again, I was not surprised to have few takers. However, recent news from Minnesota suggests that others see the potential in combining risk-taking providers with exchanges. Medica – one of the early leaders in private exchanges with Bloom Health

Rescuing the condition-focused ACO from CMS

James Matheson July 12, 2012

Summary The case for an oncology ACO can be compelling but CMS rules for ACOs within fee-for-service (FFS) make value difficult to demonstrate A new physician-hospital-payer partnership in Florida will test whether the oncology ACO model can succeed outside the CMS rules The payer partner has a limited Medicare position and the hospital partner is reputed to be high priced. Despite these potential issues, there are good reasons to think the partners are well aligned on a growth agenda for the model If the model itself proves out, however, it

Tag: provider business model

Recon takes an analytical look behind select developments in healthcare

Ambidextrous strategy: PART 1 – Payer and provider strategy for two very different worlds

Cleveland Clinic’s bold land grab in care improvement: the Community Health Systems deal

Risk-taking providers in private exchanges: Medica’s “My Plan” private exchange

Rescuing the condition-focused ACO from CMS

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