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Revolt of the Poster Boys

October 2nd, 2011 · 2 Comments

And the hits just keep on comin’ from our enlightened masters in government-run health care:

‘Poster Boys’ Take A Pass On Pioneer ACO Program:

During the health care debate, the Mayo Clinic, the Cleveland Clinic, Geisinger Health System and Intermountain Healthcare were repeatedly touted as models for a new health care delivery system.

Now, they have something else in common: All four have declined to apply for the “Pioneer” program tailor-made by the Obama administration to reward such organizations.

“When the poster boys ask that the posters be taken down, you have a problem,” says Michael Millenson, president of Health Quality Advisors LLC…

The four health systems are considered the most promising models for “accountable care organizations,” a new approach to delivering health care services that rewards doctors and hospitals for providing high-quality care to Medicare beneficiaries while keeping costs down. The ACO provision became one of the most highly anticipated elements of the health care overhaul, and providers embarked on a frenzied race to join in as quickly as possible.

But when the proposed regulation for the program was announced in March, excitement fizzled.

Hospital and doctor groups complained that the program created more financial risks than rewards and imposed onerous reporting requirements. The American Medical Group Association, which represents nearly 400 large provider organizations, responded with a letter to CMS warning that more than 90 percent of its members would not participate because of the reporting requirements and financial disincentives. In particular, the proposed rule would impose penalties for ACOs that do not achieve savings.

In response, HHS announced the Pioneer program in May, promising it would “provide a faster path for mature ACOs” like the Mayo Clinic that would allow the high-performing health systems to pocket more of the expected savings in exchange for taking on greater financial risk. HHS estimated that the Pioneer program could save Medicare as much as $430 million over three years.

The big boys in health care were so impressed by the latest-and-greatest rendition of Obamacare’s hot new ACO “reform” (which is little different than the disastrous capitated HMO model which went down in flames not so very long ago) that they responded, “Thanks, but no thanks.”

No doubt a new rendition of ACOs will be forthcoming soon, complete with a host of new regulations, onerous reporting requirements, and penalties for care which does not meet “quality” (AKA, low-cost) standards set by the government. After all, who knows more about “quality” than our sharp-witted wizards in Washington? Be afraid — be very afraid…

Centralized funding and control of health care is beyond disastrous. It is paving the road to national bankruptcy. The answer to this monstrous failure is, as always, more control, more regulations, more centralization. Sadly, like a runaway train, it hurtles down the tracks toward an inevitable trainwreck.

Let’s just hope and pray that there will be some salvageable pieces left when it all jumps the tracks. Physicians who have wedded themselves to hospital-based and other large ACO-aligned medical groups for security will find themselves among the wreckage.

The only hope for physicians in the long run is to move outside the current system of third-party payers and decentralizing toward a cash-based practice. The inevitable outcome of the coming disaster in health care (and no, our politicians won’t prevent it) is severe rationing of care, long waits for doctors visits, diagnostic studies, and surgery. For patients, catastrophic coverage (if you can get it) with HSAs will ultimately prove the safest and most reliable way to get access to health care.

Welcome to health care in the millennium.

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Tags: Health care policy · Health care reform · Medicine

2 comments so far ↓

 

  • rayman // Mar 26, 2012 at 7:39 AM

    All the mainstream media is in love with Obumacare. I keep hearing how great it will be for the poor. People keep saying how nice it will be to not pay for medical care! Do they think that it will be paid for magically? We all will pay much more than ever through taxes and higher premiums. I may not be very smart but I’ve been alive long enough to know there’s no magic and no free lunch and socialized medecine everywhere is an abysmal failure. How can anyone possibly believe it will work any better here? What about freedom? The land of the free is a little less free. By the time we realize this, it will be deadly difficult pry our freedom from the cold, cruel grasp of big government.

  • Ken // Mar 30, 2012 at 8:30 AM

    “The only hope for physicians in the long run is to move outside the current system of third-party payers and decentralizing toward a cash-based practice.”

    If it were possible to agree one million percent with this statement, I would do so. Likewise, I fully agree that the catastrophic/HSA framework is the way forward (it’s not easy to convince other, shall we say, primary stakeholders in the decision…and I am disinclined to play Pharaoh in that regard, having already condemned the state for trying to do so).