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Book Reviews, with Testimonial, by ME-P Founding Publisher Dr. David Edward Marcinko MBA CMP®
PRESS RELEASE!
August 23, 2013 – CRC Press / Productivity Press is pleased to announce the publication of Accountable Care Organizations: Value Metrics and Capital Formation authored by nationally recognized healthcare expert, Robert James Cimasi. This dynamic book explores the historical background and evolution of the highly anticipated ACO model which is rapidly expanding since its adoption as part of the Affordable Care Act, commonly referred to as Obama Care. The book describes the basis for the development of value metrics and capital formation analyses that are foundational to assessing capacity for change in healthcare organizations considering the development of an ACO, as well as, the current efficacy of the model.
Book Reviews
“Bob Cimasi has done it again. As a thought leader in contemporary healthcare matters, his new book, Accountable Care Organizations: Value Metrics and Capital Formation, establishes and explains, in plain terms, the operational and financial DNA and genomic construct and understanding for any organization considering the development and operations of an ACO…a must read and resource for any healthcare industry executive.”
-Roger W. Logan, MS, CPA/ABV, ASA, Senior Vice President of Phoenix Children’s Hospital
“Accountable Care Organizations is the first comprehensive text on capital formation and value metrics for this new healthcare business model… I can think of no one more qualified to write it than Bob Cimasi at Health Capital Consultants … it is destined to become a classic work … read, review, refer, and profit by this valuable resource.”
-Dr. David Edward Marcinko MBA CMP® of the Institute of Medical Business Advisors, Inc Atlanta, GA
“As both a healthcare management educator and as a consultant who has worked on health and professional services transactional advisory work for many years, I applaud the ambitious undertaking of Bob Cimasi’s latest book, Accountable Care Organizations: Value Metrics and Capital Formation. Cimasi’s description of the complex history and evolution of the US health system provides a useful framework for students and professionals who may lack a detailed background in the field. This should help them better understand both how we have arrived at the ACO approach, and how it might work. This addressing capital and valuation information is also uncommon in the literature on ACOs. It should provide a valuable contribution to the field, especially given that a some surveys of healthcare leaders have pointed to access to capital and to a lesser but still important degree, agreement on valuation, as concerns as they consider acquisitions, mergers, and other affiliations towards forming/joining ACOs or similar organizations to help deal with the changing reimbursement and competitive environment.”
-R. Brooke Hollis, MBA/HHSA, Executive Director, Sloan Program in Health Administration, Cornell University and Managing Member, Hollis Associates Acquisition Advisors, LLC
The book examines the Four Pillars of Value in the Healthcare Industry: regulatory, reimbursement, competition and technology in addressing the value metrics of ACOs, including requirements for capital formation, financial feasibility, and economic returns. It focuses the discussion of non-monetary value on a review of aspects of population health within the context of such objectives as improved quality outcomes and access to care. It also examines the positive externalities of the ACO model, including results for third parties outside the basic construct of the ACO contracts shared savings payments. The potential role and opportunities for consultants in assisting their provider clients in the consideration, development, implementation, and operation of an ACO are also discussed.
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About the Author:
Robert James Cimasi, MHA, ASA, FRICS, MCBA, AVA, CM&AA, CMP® is CEO of Health Capital Consultants (HCC), a nationally recognized healthcare financial and economic consulting firm headquartered in St. Louis, Missouri, since 1993. Cimasi has more than 30 years of experience in serving clients in over 45 states, with a professional focus on the financial and economic aspects of healthcare service sector entities including feasibility analysis and forecasting; valuation consulting and capital formation services; healthcare industry transactions including joint ventures, mergers, acquisitions, and divestitures; certificate-of-need and other regulatory and policy planning consulting; and, litigation support and expert testimony.
Mr. Cimasi has served for many years as faculty in both an academic and professional basis for continuing education courses, and he has provided testimony before federal and state legislative committees and has served as an expert witness in numerous court cases. He is a nationally known speaker on healthcare industry topics, the author of several books, including A Guide to Consulting Services for Emerging Healthcare Organizations (John Wiley & Sons, 1999), The U.S. Healthcare Certificate of Need Sourcebook (Beard Books, 2005), The Adviser’s Guide to Healthcare (AICPA, 2010), and Healthcare Valuation: The Financial Appraisal of Enterprises, Assets, and Services (John Wiley & Sons, 2013), as well as numerous chapters, published articles, research papers and case studies, and is often quoted by healthcare industry press.
- Accountable Care Directory 2014
- Achieving Quality in Accountable Care Organizations
- High-Performing Care Coordination in a Patient/Family-Centered Medical Home
- ‘Aetna’s Medicare Advantage Collaborative Initiatives’
- Aligning High Performance in Medication Safety to Improve Patient Outcomes and Reduce Readmissions
Source: HealthShareTV
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Filed under: Book Reviews, CMP Program, Health Economics | Tagged: Accountable Care Organizations, ACO, ACOs, certified medical planner, Cimasi, CMP™ Course, Health Capital Consultants LLC |
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 
The Accountable Care Directory 2013
[Video presented by MCOL]
The ideal resource for collaborating, networking, recruiting, marketing or monitoring of Accountable Care Organizations.
http://www.healthsharetv.com/content/accountable-care-directory-2013-version-2-intro-video
The Accountable Care Directory 2013 version 2 incorporates new commercial ACOs, updated Pioneer ACO information, as well as extensive updates to prior listings.
Hope R. Hetico RN MHA
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8 Recently Formed ACOs
1. Dallas based Tenet Healthcare Corp. and Blue Cross and Blue Shield of Texas announced they would launch a statewide ACO in January 2015
2. Munson Healthcare, an eight-hospital system based in Traverse City, Mich., signed a three-year value-based reimbursement agreement with Blue Cross Blue Shield of Michigan
3. Cigna joined forces with physicians affiliated with Boulder (Colo.) Community Hospital’s Community Medical Associates to launch a collaborative accountable care initiative
4. Optima Health, the health plan of Norfolk, Va.-based Sentara Healthcare, formed an accountable care organization network with Johnson City, Tenn.-based Integrated Solutions Health Network, an affiliate
5. Philadelphia based Jefferson Health System and Independence Blue Cross reached a two-year contract deal centered on accountable care payments
6. The Boice-Willis Clinic, a multispecialty physician-owned practice in Rocky Mount, N.C., inked a collaborative accountable care initiative deal with Cigna
7. Cigna launched an ACO with Santa Clara County IPA in San Jose, California
8. Cigna also launched an ACO with Patient Physician Network in Plano, Texas
Source: Becker’s Hospital Review
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ACOs won’t accept ‘two-sided risk’ of upcoming Medicare contracts
As more Medicare patients are being served by accountable care organizations (ACOs), and their numbers continue to grow, a recent survey by the National Association of ACOs says that many aren’t happy with the risk involved in upcoming Medicare contracts.
http://medicaleconomics.modernmedicine.com/medical-economics/news/acos-won-t-accept-two-sided-risk-upcoming-medicare-contracts
Is anyone surprised?
Oloff
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ACO Regulatory Update Proposed by CMS
On December 1, 2014, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that recommends changes to the Medicare Shared Savings Program (MSSP) for federal Accountable Care Organizations (ACOs).
Click to access ACO.pdf
The proposed rule seeks to “codify existing guidance, reduce administrative burden and improve program function and transparency” in ten areas.
Robert James Cimasi, MHA, ASA, FRICS, MCBA, AVA, CM&AA, CMP®
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M and As on the ACA
The impact of major acquisitions will differ from case to case. But, by and large, I think the effects of completed acquisitions will be modest on “providers, employers, consumers and other plans.”
By way of context, I believe that it is unlikely that significant within-market combinations will be permitted. This fact would preclude acquisitions that could increase the bargaining power of health plans with local health benefit plan sponsors or providers. Moreover, if the Affordable Care Act serves to increase the importance of the individual, versus national employer market, the benefits of acquisitions of plans that serve national accounts would diminish. Past examples of this include Empire Blue Cross and Oxford Health Plans which were purchased by Anthem and UnitedHealth, respectively.
Finally, health insurance has few economies of scale. Overall, economies of scale aren’t measurable and only few functional areas are, such as Actuarial and Corporate Executive. Finance and Accounting can be scalable but only within a single region. An exception might be for plans that are below 100,000 members, but these would likely not qualify as a “major national health plan acquisition.” So achieving economies of scale will also not motivation of compelling force.
For these reasons I think that that the only sorts of acquisitions will be those of plans endeavoring to diversify, either in products or geographic reach. While this may have important corporate finance implications, it won’t bear much on “providers, employers, consumers and other plans.” So, for example, suppose the merger of two Blue Cross Blue Shield Plans (I recognize that these are generally not really national) – it would achieve geographic diversification but other effects would be modest.
If anything, barriers to entry are falling because of the effect of ACA on the employer-sponsored health plan market. In addition, Medicare and Medicaid managed care, which serve what is effectively an individual market, are increasing their share. This plus the need to control overall costs make health systems natural sponsors of new entrants.
Douglas Sherlock CFA
[Senior Health Care Analyst]
Sherlock Company
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