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2 posts from October 2018


Upcoming Interview: Jessica Wolff Discusses Health Care Without Harm's Work To Reduce The Health Care Industry's Carbon Footprint (October 24th)

Earlier this week the Inter-governmental Panel on Climate Change (IPPC) concluded that we have just 12 years, or until 2030, to avoid global temperatures rising above 1.5 degrees Celsius.  We've already warmed by 1 degree Celisius.   This means we will have to reduce carbon emissions by 50% by 2030 and reach net zero emissions by 2050.  (The US is historically the largest emitter of greenhouse gasses and currently second behind China.  Worldwide, we currently dump 42 billion tons of greenhouse gasses into the atmosphere annually and the amount has been again climbing since last year.)  As I noted in the 3 Quarks Daily essay cited below, there is no climate analog for this century for at least the past 50 million years.  Should the atmosphere warm by 2 degrees (the Paris Climate Accord goal was between 1.5 to 2), the earth as we know it will, largely, cease to exist.  

Health Care Without Harm's (HCWH) mission is to reduce the health care industry's carbon footprint.  HCWH's task is daunting since the health care industry, with rare exception, is doing nothing to address the so called climate penalty. 

Listeners may recall last November I posted my 3 Quarks Daily essay, "As the World Burns" that lent evidence to this fact.  It is at: http://www.3quarksdaily.blogs.com/3quarksdaily/2017/11/as-the-world-burns-.html

Last August 3rd, I interviewed David Wallace Wells regarding his July 2017 New York Magazine essay, "The Uninhabitable Earth."  His essay is at http://nymag.com/intelligencer/2017/07/climate-change-earth-too-hot-for-humans.html?gtm=bottom&gtm=top 


150th Interview: Tim Gronniger Discusses the Current Proposed Medicare Accountable Care Organization (ACO) Rule: October 3rd

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Currently, CMS is accepting public comment on a proposed Medicare Shared Savings Program (MSSP), known more commonly as the Accountable Care Organization (ACO) program, rule.  The MSSP, created under the 2010 Affordable Care Act, is Medicare's flagship pay or performance program currently providing care to over 10 million Medicare beneficiaries.  MSSP or ACO performance, or to the extent the program has reduced Medicare spending growth, has been widely debated largely because CMS has failed to evaluate the program  Under this administration the program has come under substantial criticism.  The proposed rule, published this past August 17 in the Federal Register, is this administration's effort to improve the program's performance moreover by reducing the number of years an provider can participate in the program, from six years to two, without taking financial risk or participate in what are termed upside only contracts.  The administration argues absent financial risk providers do not fully engage in practice reforms to reduce spending.  This assumption is also widely debated.  Absent other substantial payment innovations, the success of the MSSP or ACO program is vital to the Medicare program, now forcasted to go bankrupt in 2026. 

During this 30 minute conversation Mr. Gronniger begins with a a brief overview of Caravan's work, he discusses or explains what success the ACO program has achieved to date and the program's background.  He moves onto discussing numerous elements of the proposed rule including earned shared savings percents, risk adjustment, aspects of financial benchmarking, low and high revenue ACOs, and beneficiary engagement and incentives, among others.     

Mr. Tim Gronniger is currently the Senior Vice President of Development and Strategy at Caravan Health.  Previously, he Gronnigerserved as Chief of Staff and Director of Delivery System Reform at CMS.  Previous to that, Mr. Gronniger  was Senior Adviser for Health Care Policy for the White House Domestic Policy Council.  Before that he served as senior professional staff to the Ranking Member of the House Committee on Energy and Commerce, Rep. Henry Waxman (D-CA, now retired).  Mr. Gronniger began his career in Washington, D.C. at the Congressional Budget Office where he studied or scored Medicare and Medicaid legislation.  Mr. Gronniger holds a Masters in Public Policy and Health Services Administration from the University of Michigan and a BA in Biochemical Sciences from Harvard. 

The proposed ACO rule is at: https://www.federalregister.gov/documents/2018/08/17/2018-17101/medicare-program-medicare-shared-savings-program-accountable-care-organizations-pathways-to-success

For information concerning Caravan Health go to: https://caravanhealth.com/