Trends That We Are Reporting On Our Facebook Page

Almost 70 percent of Americans now have access to an accountable care organization for their health needs

Although growth slowed the number of ACOs still rose by about 16 percent; number of patients served rose 6 percent, said consultant Oliver Wyman.

Almost 70 percent of the U.S. population now lives in localities served by accountable care organizations, and 44 percent live in areas served by two or more, found new research by the Oliver Wyman consulting firm.

The total number of ACOs participating in Medicare programs has increased to 426, up from 368 in January 2014, the study found.

About 5.6 million Medicare beneficiaries, or about 11 percent of total Medicare beneficiaries, now receive their healthcare from ACOs participating in Medicare’s ACO programs.  https://www.facebook.com/TheMCIC

Source:  Oliver Wyman Study  http://www.oliverwyman.com/

What ‪‎Physicians‬ Earned in 2014 – New Results

“On average, specialists earned $284,000 a year while primary care physicians earned about $195,000, according to a new survey, which polled 19,500 physicians across 25 specialties.”

Orthopedists‬ earn an average of $450,000 a year. Cardiologists were earning a average total of $395,000 a year, the survey found.

On the lower end, pediatrics showed the lowest total compensation at $196,000, though exactly half said they felt fairly compensated. Also, 50 percent of pediatricians polled were women.

The average compensation for a self-employed male physician was $324,000, compared to $259,000 for female physicians.  https://www.facebook.com/TheMCIC

Source: Health Care Finance  http://www.healthcarefinancenews.com/

———————————————————————————-
Directories of Healthcare Payers and Provider Organizations From the Managed Care Information Center

Searching for contact information about managed care organizations, health systems and hospitals or such physician organizations as independent practice associations or physician hospital organizations visit our Directories of Health Insurers and Providers page at Health Resources Online.

https://www.healthresourcesonline.com/directories-of-health-insurers-and-providers.html
————————————————————————————-

“A small percentage of patients are responsible for the majority of healthcare spending in the United States,” study finds.

The top three percent of patients categorized as persistent high users accounted for 21 percent of total annual healthcare expenditure for a typical large business in Pennsylvania, found the study published this week in the American Journal of Managed Care.

Persistent high users incurred annual expenses of more than $38,000 compared to just $2201 for patients who never crossed the “high use” threshold, the study researchers said. While some patients experiencing acute issues or hospitalizations temporarily incurred high expenses, patients experiencing a higher burden of sustained chronic conditions were significantly more likely to be frequent users of healthcare services. https://www.facebook.com/TheMCIC

Source: Healthcare IT Analytics  www.http://healthitanalytics.com/

 

Advertisements

Health Systems Seen Needing New Strategies to Reorganize Delivery Models

To succeed in this new post-health reform arena, Health systems should prioritize information technology infrastructure development, information sharing, and timely distribution of information to ensure outstanding patient care, prepare for a patient-centered medical home and bundled payment system, and move toward best practice levels of care coordination, according to Health Strategies & Solutions, a Philadelphia-based consulting firm.

“The Supreme Court decision to uphold the major provisions of the ACA launches a new era in health care in the United States. Development of a robust foundation of primary care services must move to the forefront of strategic priorities for all health care providers,” the firm, with offices in a number of states, says in a white paper.

According to the firm’s white paper “Primary Care In An Era of Healthcare Reform” health care organizations that  Continue reading

25 Percent of Provider Reimbursement Seen Tied to Performance

Over the coming decade, a third (35 percent) of doctors expect that between 10 percent and 25 percent of provider reimbursement will be tied to performance.

And, a fifth (22 percent) of doctors think that the proportion at risk will be in excess of a quarter of reimbursement.

Half (49 percent) of physicians say they currently feel “not at all prepared” to accept greater financial risk for managing patient care, found a study by the Optum Institute for Sustainable Health.

http://www.institute.optum.com/

Inside Report: IPAs – PHOs Definitely Worth Another Look

Independent practice associations (IPAs) and physician hospital organizations (PHOs) have risen to a prime position in the healthcare provider market, especially in recent months.

Imagine physician organizations were written off for dead just a few years ago. Impatient for successful results, hospitals and physicians were shutting down their PHO partnerships.

The smaller IPAs just faded away – just another healthcare ‘gimmick.’ A failed idea.

So the overall numbers of physician organizations has shrunk in terms of numbers of organizations, according to our research results for the National Directory of Physician Organizations Database, produced by the Managed Care Information Center.

But the PHOs and IPAs with sharp leadership stuck with it. And, today they are stronger and importantly positioned to be significant players in today’s changing provider arena.

First the major IPAs across the country proved that they were indeed viable. Led by sharp executives and leadership, patients and health plans and their members came.

“If you build it they will come.”

After a few battles with the federal trade commission physician organizations got the FTC’s green light for clinical integration initiatives.

The exploding wave of pay-for-performance programs reinforced that IPA and PHO member physicians could ramp up their quality of care measures and patient satisfaction numbers.

Because of the success of IPAs, there has also been a wave of consolidation further strengthening their position in the marketplace.

Health and managed care executives have told us about what’s shaping today’s market.

“Health Reform…it is changing the entire playing field; Significant changes in the relationships between payors, providers and patients due to health reform; tiered networks that exclude academic medical centers; Continuing movement from government and payors to P4P programs (heavy emphasis on quality); and, P4P will be easier for large carriers to implement than any real payment reform,” were among just a few of the observations shared by participants in the Managed Care Leadership Survey.

Now, even as rules governing accountable care organizations have just been proposed by the Centers for Medicare and Medicaid Services (CMS) physician organizations in several sections of the country have been out-of-the-gate first.

Physician organizations now have as physician members a major number of the practicing primary care and specialist physicians in the country.

And, as they continue to bulk up, physician organizations are having to upgrade their infrastructure, IT systems, and processes.

A rising tide does indeed float all boats; at least the IPA and PHO crafts.

Bob Jenkins

Bob Jenkins is the CEO of the Managed Care Information Center.

Research source: The National Directory of Physician Organizations Database

http://www.healthresourcesonline.com/payer-provider-data/the-national-directory-of-physician-organizations-database-on-cd-rom.html

Copyright 2011, The Managed Care Information Center, 1913 Atlantic Avenue, Ste 200, Manasquan, NJ 08736  (800) 516-4343

Evaluating Oncology Management Programs: Trends in Payer Oncology Management and What You Need to Know for Success

MANASQUAN, NJ — Payers and providers across the country are grappling with choices for programs regarding oncology management and potential collaboration to control costs while also increasing the effectiveness of care.

There is a lot of discussion and many models being proposed for management of oncology costs. Both physicians and payers are seeking information to help in separating the wheat from the chaff and looking for help in choosing the best model for their needs especially in this challenging climate.

Evaluating Oncology Management Programs:Trends in Payer Oncology Management and What You Need to Know for Success is a 60-minute audio webcast scheduled for December 2, 2010, at 1:30 p.m. EST.

This program identifies the issues of concern in oncology management, outlines the current seven models under discussion/implementation, and reviews the players, pros and issues with each model.

Participants will learn how to:

  • Evaluate the results of two oncology trend reports while learning key perspectives on oncology policy and management from both payers and physicians as well as implications of the study results
  • Review the details of oncology management and collaborative models in play across the country, including drug pricing, guidelines and pathways
  • Understand how to evaluate the current models and what questions to ask in choosing a best fit for your organization
  • Develop strategies regarding oncology management and take away steps for implementation and collaboration with oncology providers

The session also includes:

  • Live Open Line question and answer session

The presenter for the program is Dawn G. Holcombe, president of
DGH Consulting and is sponsored by The Managed Care Information Center.

For complete details, please visit:
www.healthresourcesonline.com/edu/Evaluating-Oncology-Management-Programs.htm

Accountable Care Organizations – Shaking up the Medicare Reimbursement Status Quo Big Time

CMS is supposed to issue proposed regs governing ACOs this fall.

Then, expect the first ACOs to begin operating in January 2010 – just 15 months away!

We have organized an education program on ACOs this Thursday. Should be an eye opener.

Healthcare providers, hospitals, PHOs and IPAs and others, payers and even vendors need to be aware of the implications for the market and competition in the new ‘hot issue’ era of ACOs.

Hospitals, PHOs, IPAs and other physician organizations, networks or group practices need to make some quick decisions about ACOs.

If your organization is considering creating an ACO, you have no time to lose.

About the program – “Accountable Care Organizations: The Opportunities and the Risks,” a new management education audio webcast briefing, this Thursday, Sept. 30, 2010 from 1:30 PM – 2:30 PM EDT.

For details click on: http://www.healthresourcesonline.com/edu/Accountable-care-Organizations.htm