The 100 Year Shift? Part 4 On Why Physicians Still Have Plenty Of Reasons To Remain Independent

"After looking at the proposed buy-out
contract, I need some of this gas...."

The e-CareManagement series on the 100 Year Shift continues with this latest post, "The Practice of Medicine: from Marcus Welby to ???"

Readers will recall that this is the 4th in a series of blog posts that argues that physicians and health insurers are destined to become partners in the drive to increase quality and reduce unnecessary health care costs.  While the common wisdom is that physicians and hospitals will aggregate into large regionally dominant provider organizations, your Disease Management Care Blog and the talented and insightful Vince Kuraitis have a contrarian point of view.

Think we're wrong?  Keep in mind that we've gotten a lot of supportive comments and invitations to review this in greater detail in some national forums.  If you think we're all wet, tell us why.  We need to learn from you.

The 100 Year Shift? Part 3 On Why There Is Less To Physician-Hospital Integration Than Meets The Eye

What's ahead?

The third in a series of provocative essays on the emerging alignment of health insurers and physicians has been posted at Vince Kuraitis' e-CareManagement blog. 

In it, we review the transition of hospitals from "revenue" to risk-bearing "cost" centers and speculate on how physicians are likely to react.  While perceptive Disease Management Care Blog readers may ask about the recent spate of physician practice purchases by hospitals as well as the looming specter of "accountable care organizations," Vince and the DMCB have eight reasons why hospital-physician marriages have a lot more Schwarzenegger and a lot less steadfastness than generally appreciated.

Is the DMCB's prognostications full of hot air?  A flight of fancy?  Wishful thinking?  Read for yourself and decide.  Comments remain always welcome.

Image from Wikipedia

What Can Highmark's Merger with West Penn Allegheny Teach Us About the 100 Year Shift?

The ever self-promoting Disease Management Care Blog is quoted on the July 17 front page of Pittsburgh's premier newspaper, the Post Gazette.  In it, the DMCB holds forth about the Highmark Blue Cross Blue Shield merger with the West Penn Allegheny Hospital. 

Readers may recall prior DMCB posts (here and here) predicting the unwinding of physician-hospital alignments and the corresponding rise of physician-insurer chumminess.  While the Highmark to-do is a hospital-insurer merger, the DMCB speculates that Highmark's circumstances are skewed by a) West Penn's financial travails and b) Highmark's business need to have a low-cost inpatient alternative to the behemoth University of Pittsburgh Medical Center (UPMC) monopsony. 

The DMCB won't let a few facts get in a the way of a good generalization. It discerns the same underlying dynamic at work: consternation over rising inpatient-related costs and recognition that physicians are the key to achieving value. Look to Highmark supporting West Penn as a low-cost alternative to UPMC while it tries to curry favor and build bridges with the hospital's medical staff.

The 100 Year Shift? Part 2 On The Transformation Of Payment From Volume to Value

Can't wait for Part 3!

As promised, the second part of the audacious series  on "The 100 Year Shift" has been posted at Vince Kuraitis'                e-CareManagement Blog.  Co-authored by your Disease Management Care Blog, this latest addition looks at why payment reimbursement for "value" is trumping "volume," how this is driving increased "accountability" (of which ACOs are merely one version) and the looming shake-up of hospitals, physicians and insurers. 

If you accept our logic, it's easier to see why insurers remain quite powerful, hospitals stand to lose the most in the current U.S. deficit reduction negotiations and the physicians may have a shot at reversing the scheduled sustainable growth rate (SGR) cuts.

Part 2 is posted here.

Whether you think this is naive, delusional or the work of buffoons, your interest is appreciated and comments are always welcome.

The 100 Year Shift? Introduction and Overview



Coming to an end?

The Disease Management Care Blog is proud to introduce a series of jointly authored postings on the topic of "The 100 Year Shift" that will be hosted by Vince Kuraitis at the e-CareManagement blog.

This series will examine a major shift underway in the hospital-physician-insurer triad.  While hospitals and physicians have been closely affiliated for decades, we suggest that this historically cozy relationship may be coming to an end.  What's more, we brazenly predict that health insurers (yes, insurers) and physicians will find that they have more in common, leading to a significant new alignment between these two entities.

"Hmph!" you say? "No way!" is your reaction?  You think the DMCB has really gone off the deep end this time?  You may be right, but check out the posts and then decide if any of it could be possible.

The first introductory post is here.