Georgetown lost in the Big East semifinals and settled for a No. 2 as well, but Indiana was in no danger of dropping off the top line, despite its loss to the Badgers.

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"Our strength comes from being part of Schlumberger, " says Rostand, 46, who manages his own profit and loss line and has to land his own clients--no piggybacking on the mothership.

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While the insurance companies may know that their present business model is reaching the end of the line (thanks, in no small part, to the Medical Loss Ratios), they are smart enough to recognize the next business model when they see it and will likely proceed to own and operate the ACOs.

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