Skip to main content

Are Single-Specialty ACOs In Your Future?

AIS's Health Business Daily: "US Oncology May Go National With Private-Sector Accountable Care Organization."
"Leonard Kalman, M.D., who is one of several medical directors for the huge for-profit oncology practice-management firm and chairman of the board of managers of Miami-based Advanced Medical Specialties, says that he thinks US Oncology-affiliated practices as a whole, including his, are interested in exploring such commercial ACO-like ventures. In fact, he says, a major hospital in Miami has approached his 40-physician practice about handling cancer care in such a way. “Our ACO partner is a dominant hospital system where we put basically all of our patients,” he says, declining to name it.

"When cancer becomes the primary diagnosis, the oncologist basically handles the patient’s primary care, Kalman explains. “Remember, the majority of an oncology patient’s care is cancer care,” he says. So while ACO patients may require occasional care from other sources, including primary care physicians or specialists such as cardiologists or rheumatologists, only oncologists would be affiliated with a Medicare oncology ACO as he envisions it."
An intriguing idea, though I'm hearing echoes of mid-1990's style risk contracting where specialty carve-outs were common and, ultimately, counterproductive.   An "every specialty for himself" model, where the impetus is simply preserving market dominance and pricing power, further fragments care to nobody's benefit, least of all the patient's.  The more THAT happens, the more the entire system is put at risk.

Comments

Popular posts from this blog

Behind Every Resume Is A Potential Customer...and Karma.

I recently heard from an executive colleague who, thanks to a merger, found herself looking for her next opportunity. Her story, probably depressingly familiar to many of you, was all about the big black hole of rudeness and non-responsiveness that so often sums up employers' attitudes toward candidates.

This colleague, thinking she'd see the healthcare world from a new vantage point, pursued opportunities with consultants, IT vendors, architects and other suppliers who, far from appreciating her solid resume, were like the 3 Stooges of clueless.

So back to a senior health system role she went, WHERE SHE NOW INITIATES AND MANAGES RFPs FOR SOME OF THE VERY SAME COMPANIES who wouldn't talk to her as a candidate, but profess their LOVE for her now that she's got money to spend on their services.

Not gonna happen. Any guesses who's off the RFP list?

I smiled when I heard her story, imagining the BusDev people working hard to grow the revenue pipeline, all the while b…

Becoming Consumer Friendly In Five Easy Steps...Or Not

An article at hhnmag.com offers hospitals 5 steps to becoming more consumer friendly.

If you still think there's a secret sauce to your hospital becoming more "consumer friendly," these 5 steps are as good a place to start as any.  Unfortunately, it's a little like that old Steve Martin comedy bit where he says he'll teach you how to be rich. The first step is to go find a million dollars.

Step 1 from the article is realizing that "...a Medicare beneficiary with chronic conditions is different from a young mom who brings her kids in for an annual check-up." This is market segmentation for beginners, and, yes, one size decidedly does not fit all. I'm sure your marketing team's been saying this for a while.

Steps 2-5: have a strategy, metrics, a champion and resources. OK. Hard to argue with any of those.

But those things, alone or together, won't overcome culture. They're important components to be sure, but insufficient without a …

The Answer For Lower Healthcare Costs Is...

...Customer Service.

From the New York Times: Seattle's Iora Primary Care is a new model of primary care, seeking national scale and venture capital funding.  Though the ambition may be outsize, the concepts are not new. Daily team huddles. Health coaches. Taking satisfaction surveys seriously and mining results for actionable insights. Employer and payer partnerships. Pay-for-performance not volumes. Loose-tight operations (wellness options are "loose" - i.e. varying from site to
site, while EHR alignment is "tight" and non-negotiable.)

According to the article:
"...small change(s) can make a big difference in a patient’s health — what good is the perfect drug if the patient can’t swallow it? — but the extra-mile work it took to get there can be a challenge for the typical primary care practice in the United States. Harried by busy schedules and paid on a piecework model, many doctors rush from visit to visit, avoid phone calls and emails that …