Now available for public comment: 429 pages of proposed ACO rules from HHS.
Aetna Inc. (Hartford, CT) will use the acquisition of health information exchange company Medicity as a platform for pushing clinical decision-support applications to providers – a cornerstone of the company’s ACO strategy – according to Meg McCarthy, executive vice president of innovation. McCarthy made the comments at the Next Generation in Managed Care IT forum in New York this week, noting that while Medicity has a “good, strong core business,” the strategy is to leverage the Medicity platform to offer applications from Aetna’s ActiveHealth clinical decision-support division. Expanded coverage appears in this month’s ACO Market News.
Babette Apland, senior vice president of health and care management at HealthPartners in her keynote address at the New Directions for Health Plans conference, Friday, March 25:
If ACOs are going to take risk then why do we need health plans?
A Deloitte study estimates that the hidden cost of healthcare in the U.S. in 2009 was $363 billion — most of which is the imputed value of “supervisory care,” i.e., taking care of a sick or disabled spouse, family member or friend. The rest is for products and services not counted in the annual government tally of healthcare expenditures, like spending on nutritional supplements, mental health and substance abuse facilities, alternative medicine, certain ambulatory and ambulance services and weight-loss centers.
Source: Deloitte. Based on $363 billion in estimated hidden U.S. healthcare costs in 2009.
Here’s an interesting chart from the San Francisco Health Service System illustrating a steady migration among enrollees to Kaiser’s staff-model health plan and away from Blue Shield of California. In an attempt to stem the loss of share, Blue Shield-CA has entered into an ACO with Brown & Toland and Sutter’s California Pacific Medical Center. Complete coverage in ACO Market News.
According to McKinsey Quarterly, a six-year-old type 2 diabetes disease management program instituted by Germany’s national statutory health insurance system is showing signs of success. In 2009, the program had nearly 3.2 million enrollees. McKinsey argues that successful disease management programs tend to have five common traits: large size and scale, simple design, a focus on patients’ needs, the ability to collect data easily, and incentives that encourage all stakeholders to comply with the program.