A "HealthTweep" Pulse Check

Exploring transformational potential of social media

Posts Tagged ‘Gregg Masters

The ‘Medical Aggregators’: Are We Entering Round Deux?

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First a little historical context:

For those with a healthcare ‘event horizon’ slightly more seasoned than the current health reform and related social media data frames, you might remember the initial round of aggregation in medicine lead by disruptive nameplates such as MedPartners (now operating the PBM CareMark), PhyCor, FPA Medical Management, and their second or third tier physician practice management ‘me too’ copycats.

They all emerged from a robust round of venture capital backed industry determination tagged as ‘PPMC’s’, i.e., physician practice management companies. These ‘aggregators’ were the darlings of Wall Street for a while, though with some exceptions, i.e., US Oncology (formerly Physician Reliance Network), most witnessed relatively short life spans, from IPO to unwinding in perhaps a 10 year run (see: MedPartners collapse and Aftermath).

Yet, despite the promise outlined in the offering prospectus’, why did these entities fail so miserably as the ‘white knight’ consolidators or aggregators of a multi-trillion dollar ‘cottage medical industry’? Their business model proferred essentially three core benefits:

  1. Centralized, standardized and more efficient back office medical administrative management
  2. Scale of market asset concentration and therefore increased sophistication and leverage (improved pricing) with third party payor negotiation, and downstream contract management; and
  3. Serve as an ‘anchor play’ with respect to the broader design and implementation of rational though market based local delivery organization and financing, i.e., PPMC’s would harness and more effectively articulate a business culture among physicians that valued clinical integration, medical risk management, and ultimately the allocation of limited health care resources

At least this was the longer term expectation from a ‘win/win’, i.e., payor and provider perspective, of the more established players. Most however, in an effort to demonstrate value (i.e., earn their management fee) to their physician boards, focused on short term margin improvement (better rates, focus on more profitable services via improved payor mix, maximizing the contract revenue/recovery cycle, and reduced overhead, etc.), vs. the strategic focus of managing the risk (both quality and cost) of their local population (i.e., enrolled members).

So rather quickly the strategic basis of the PPMC appeal was subordinated to a short term focus (i.e., increasing net revenues) due to a rising chorus of claims that at its core the business model was merely a third party ponzi scheme which introduced another mouth to feed from an increasingly constrained health care supply chain.

Net/net, the PPMC industry flamed out big time and did not fulfill its ‘roll-up’ promise of the practice of medicine. Now many years later, we are at another tipping point. Witness the current round of promising vehicles with a similar vision of organizing physicians. These candidates include: hospital systems, health plans, integrated delivery systems, emerging ACOs, medical homes,  and even niche play organizers in the concierge, or direct practice space including SignatureMD, MDVIP, HealthAccess Rhode Island, CarePractice, Qliance, and HelloHealth, as well as the rapidly emerging series of retail pharmacy sponsored primary care clinics, e.g., CVS/CareMark Minute Clinic, etc.

Too many docs are unwilling to risk the capital of private practice, and instead are looking to hook-up with one or more of these institutional or VC backed entrepreneurial sponsors. Will they succeed where their predecessors failed? If so, why?

From my perspective, it will clearly depend on the business model chosen to enable competition of the right variety, and the degree to which the venture embraces, nurtures and expresses physician culture that values collaborative group practice. Top down, corporate strategies dependent upon an over worked and out gunned medical director or VP of medical affairs will miss the mark. The more likely way for these ventures to succeed is by ‘baking’ the culture from the ground up. In other words, ‘seed it and they will come’. One of my mentors (Ernest Holmes) once wrote long ago: ‘the soil can’t argue with the seed’. Lets nourish the soil first, then make sure we plant the seeds with the right constitution and vision.

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Health Care Web Literacy with HealthTweep & Thought Leader @PhilBaumann

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On Tuesday’s broadcast at 9 AM Pacific and 12 Noon Eastern, I will chat with Phil Baumann on our nascent yet rapidly emerging new media, aka ‘social’ industry. We will talk about a range of issues from web literacy to content building, promotion, branding and attempts at monetization.

For more information on Phil see his blog here; and Twitter page here. Phil is a witty, generous producer and insightful publisher of social media pieces; a sampling of which can be seen via:  140 Health Care Uses For Twitter, The World’s First Twitter Chat for Nurses: RNchat, and Google Is Watching You: Building Your Reputation on Google.

We invite your participation in the program via call in, chat or Tweetstream’s of @PhilBaumann or @2healthguru; the call in phone number is 347.539.5527.

Written by 2healthguru

January 18, 2010 at 3:13 PM

Ed Bennett on Trends in Social Media for Hospitals & Health Care Organizations

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Please join me for a conversation with Ed Bennett!

On the Wednesday, January 13th ‘Trends in Social Media for Hospitals and Health Care Organizations‘ broadcast I am pumped to chat with Ed Bennett of ‘Found In Cache: Social Media resources for health care professionals’ as well as his day job at the University of Maryland Medical System.

I affectionately refer to Ed (rumored to be a die hard Cowboy Junkies aficionado) as the Social Media for Hospitals ‘Oracle’ from Maryland. Ed is a leading voice, documentarian, and visionary change agent in the social media for health care organizations’ space. His tireless commitment to track, update, educate, share and vet emerging health care organizational participation in social media is a major contribution to the granular evolution of the space. Please join me in this conversation with Ed! You can call in with questions or active participation via 347.539.5527, or participate in the chat room;  or as many do, just lurk. All are welcome!

The program airs at 12 noon Eastern time, 9AM. If you can not make it live, it will archive here for rebroadcast or download. I like to subscribe to episodes and listen at my convenience via Google Reader. iTunes of other RSS feed burner.

Health Reform Conversation With David Harlow

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Come join us on Thursday, June 11th at 3 PM EDT and 12 PM PDT, we’re broadcasting live on BlogTalkRadio. If you can’t make it the program will be archived on the site and also available for download or RSS feed via Google Reader, iTunes or others. The call in number is 347.539.5527.

As we continue our journey down the health reform path, we may be witnessing the equivalent of a “healthreform 2.0” moment.

It’s been a while since the last dance circa 1993 when “HillaryCare” preoccupied the hearts and minds of many. This sound byte mantra was popularized by the ‘Harry and Louise’ campaign, and reduced a complex debate into the equivalent of a “cock fight”.

Yet, the subject is now back front and center in the national debate and with considerable traction as well as an interesting mix of coalition parters. So where do we stand? and what are the realistic legislative options before the Congress? On this program David Harlow, aka @healthblawg of the Harlow Group, will join me in this opening conversation in our maiden voyage into the health reform market place of ideas.

Please join us, and please add to what is likely to be a lively exchange. The Twitter hashtag will be #nhr (net health reform).

Written by 2healthguru

June 10, 2009 at 6:31 PM