Learning From Kaiser and Optum

A recent headline, “With 8k more physicians than Kaiser, Optum is ‘scaring the crap out of hospitals’1 is resonating within the hospital sector, as it reinforces what many hospital system executives are facing: either becoming a partner – or fearing becoming a “cost center.” The article’s premise – that two behemoths are battling it out for […]

The Evolution and Future of the NY Health Home Program

Background In 2010, the Affordable Care Act provided states the option to implement a “health home” (HH) care management model, with the goal of improving care coordination, reducing costs and improving health outcomes for high-need Medicaid members with chronic conditions. In an attempt to bridge resource gaps for a particularly complex segment of the population, […]

CMS announces new Medicare-Medicaid ACO model

On Thursday, CMS announced the creation of a new ACO model geared toward patients who qualify for both Medicare and Medicaid, also known as dual eligible. Dual eligible patients typically have more complex health needs, chronic conditions and social issues than the general Medicare population.  Consequently, they account for a disproportionate share of spending in […]

The Evolution and Future of the NY Health Home Program

Background In 2010, the Affordable Care Act provided states the option to implement a “health home” (HH) care management model, with the goal of improving care coordination, reducing costs and improving health outcomes for high-need Medicaid members with chronic conditions. In an attempt to bridge resource gaps for a particularly complex segment of the population, […]