2013
Just before finding this article I read another in the New York Times lauding the preliminary success of hospital based Accountable Care Organizations (ACOs). ACOs hope to better coordinate care among all of a Medicare patient’s providers and Medicare is providing financial incentives (and risk) to ACOs to take on the task. In concept it’s a good idea and in some settings it should work, but there are some major flaws such as the one highlighted in bold below. This is an excerpt from an article on Bloomberg Business Week about hospitals that find the risk too much to manage.
Better managing all of a patient’s care and better coordination of care, Medicare or otherwise, is essential to any possibility of spending more efficiently on health care. Obamacare attempts to encourage that, especially for Medicare. Some things may work, others won’t; only time will tell.
What is disturbing is the politicians and blind supporters of Obamacare claiming victory and more affordable health care today as a result of Obamacare. That simply is not yet known and as of today, not true. As far as the ACOs go, Medicare hasn’t even complied the data yet. Obsessed opponents of Obamacare dismiss every effort and dismiss ACOs as coming between the patient and their doctor, that too is not true. Opponents have yet to come up with viable options other than free market competition, which when it comes to health care, is a dream.
Financial Implications
Providers think “they can obviously sort of improve the way average care is delivered,” Blendon said. “They don’t realize “there can be some very expensive, difficult situations, or that they may have groups of patients moving around they don’t have the clinical control over they thought they’d have. This can have very serious financial implications for them.”
Presbyterian Chief Executive Officer Jim Hinton, who is also the chairman-elect of the American Hospital Association, warned of potential problems in the Pioneer program in an April 30 interview.
Participating hospitals are responsible for controlling costs for a population of Medicare patients assigned to them, but their ability to manage the patients’ care is limited, Hinton said. For example, they can’t forbid the patients from seeing doctors or other health providers who aren’t part of the Pioneer system.
Also, Medicare has lagged, by about six months, in providing the Pioneer systems medical claims data they need to track spending on their assigned patients, according to Hinton.
via Hospitals Threaten Obamacare Savings by Exiting Care Program (1) – Businessweek.
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