Pendulum in the News

This Kaiser Family Foundation Article provides an in-depth look at possible Affordable Care Act (ACA) replacement proposals as well as provides materials for readership to put together a thorough comparison of each.

Plans available for comparison:

  • The Affordable Care Act, 2010 (PDF)
  • Rep. Tom Price’s Empowering Patients First Act, 2015 (PDF)
  • House Speaker Paul Ryan’s A Better Way: Our Vision for a More Confident America, 2016 (PDF)
  • Sen. Bill Cassidy’s Patient Freedom Act, 2017 (PDF)
  • Sen. Rand Paul’s Obamacare Replacement Act, 2017 (PDF)

Click here to visit the article and run the comparison report provided on the site. You may compare up to 3 plans using the comparison tool.

In a Q&A style blog article, Mark Miller of RetirementRevised outlines how Medicare "modernization" proposals under a GOP majority government will affect enrollees.

Click here to be directed to the article on RetirementRevised.com.

How Repealing Portions of the Affordable Care Act Would Affect Health Insurance Coverage and Premiums.

Click here to download the Congressional Budget Office's January 2017 article discussing the ways that repealing portions of the ACA will affect health insurance coverage and premiums.

TRUMP HEALTH CARE 11/17/16

Client Advisory on what we know so far.

Our Team has sat through several sessions including with members of the Trump transition team, Deloitte, McDermott, Will, and reviewed as many blogs from experts as we could find on both sides of the aisle. While there is definitely an advantage for Trump to not answer definitive questions there are some strategies now moving forward that will change the ACA.

Our conclusion is that Trump will try to repeal the ACA using Reconciliation instead of a vote. A vote requires 60 members of the Senate to agree and the GOP, while dominate, does not have the votes. Reconciliation requires 51 and they already have experience getting this process through the Senate with HR 3752, but it was vetoed by Obama. This represents a blueprint for what will happen. Reconciliation has its limits however, and that is the points in the law that would be changed can only be changed if they are items of current or future revenue.

Independent Pharmacy Accountable Care Organizations

...William DeMarco, August 26, 2015: "Drug stores as care outlets versus retail vendors can make a very big difference in areas of managing drug costs and adherence. The leading cause of readmission to a hospital is non-adherence to drug therapy - which puts people in the ER. This is a classic example of a Preventable and Avoidable Cost (PAC) that could be better managed on an outpatient basis by having care coordinated by the pharmacists and the PCP."...

CareFirst Says Its PCMH Program Showed Savings Over Four Years

... According to William DeMarco, president at Pendulum HealthCare Development Corp., “part of the manner in which payment and bonuses are shared may also slow down innovation as the CareFirst payment schedule goes to small groups of physicians, not individual physicians. So to wring out more savings means there needs to be more tools given to the PCMH to enforce change within their group ...

Independent Pharmacy Accountable Care Organizations

... the cost of pharmacy will continue to rise as medical research promotes more effective drugs, we know employers and health plans can better manage utilization and patient experience at the delivery point of care, and that is, for many, the local home town pharmacist ...

New PHOs Are Being Structured As Stepping Stones to ACOs

... sure it works equally well for both parties,” William DeMarco, CEO of Pendulum Healthcare Development Corp., tells ABN . “In the ... each other for any financial benefits to be gained,” DeMarco says, “and this failed to produce the kind of integration needed to ...

Health Reform Accountable Care Organizations: Strategies for Health Plans and Providers

Speakers William DeMarco of DeMarco & Associates, Inc., Bruce Fried, J.D. of SNR Denton, and Randall ... shared? ### Speakers ### {#speakers} WILLIAM DeMARCO is the president and chief executive officer of DeMarco & Associates...

Health Plan Business Hospitals That Don’t Move on ACOs Risk Losing MD Referrals

... valuable assets — their physician referral base. Bill DeMarco, CEO of Pendulum Healthcare Development Corp., predicts that if local ... and employers, making the hospital a last-resort provider. DeMarco and others point to sophisticated physician groups such as Sharp ...