Health Care Thoughts: Accountable Care Part II
Health Care Thoughts: Accountable Care Part II
Accountable care organizations (ACOs) are the keystone of PPACA (Obamacare) as far as restraining costs and improving quality.
Early this year there was great excitement about ACOs in the provider community, but the publication of the (first phase) Medicare ACO rules threw cold water on everything.
The rules were at best complicated and convoluted and providers ran for the hills. The administration tried calming the fleeing providers with fast track and modified programs, without much success.
On October 20th the Obama administration published revised Medicare ACO rules. Most of us are still reading and analyzing, but the early response seems more favorable. A more detailed analysis will follow soon.
The administration finally got smarter and announced modifications to antitrust policy so Obama’s DOJ would not be wrecking the work of Obama’s DHHS.
Bad news though, employers and insurers see the possibility of intense ACO activity as anti-competitive.
Tom aka Rusty Rustbelt
Over at DeLong it was observed in comments that the US G would be in surplus now if the medical costs were in line with the OEDC average.
If war were reduced by $400B a year to be about the same percent of outlays as the United Kingdom, and US health care costs were similar to OEDC average the US would have a surplus.
Further, how many trillions have been ripped from the productive economy by bailing banksters since 1996, wars for profits, and permitting medicine to be run by insurance companies?
Regulation gives republicans’ angst because their banksters want to waste trillions in working Americans’ pension funds and then be bailed out when they waste their own reserves in their usurious gambits.
Occupy Wall Street
This information is from AAPPO. George Washington had it right, from a long time ago of course, party affiliations are to be avoided. If we can’t depend on our politicians to read a bill and know what it will cost before they vote on it due to party affiliation, we are really in trouble as a country.
http://www.austinurgentcare.com
The new simplified (really) ACO rules are 696 pages long.
Comments are starting to roll in, and if we gave it a grade is would be an improvement from F to C-.
Someone in the Obama administration needs to get the bureaucrats under control.
Rusty,
In 1991 and 2 the Sec Def got “us bureaucrats” under control. They streamlined acquisition and took away all the spec and standards, many of which had no commercial equivalent.
Now, after 20 years of messing around there are new (many modeled after the MIL STDs)commercial processes being adopted to do system engineering, and product data but none to do testing which is why the US acquisition system is overrunning an average of 40% and underperforming.
Sometimes those pages have value.
Ask why the F-35 is years behind and it is lack of process in the main, with an inherent iunability to stop paying folks that own congress.
But yes
Process is bad if not enforced, see using derivatives and bets on Euro defauklts as assets on the balance sheet.
Process can also become the iceberg that sinks the ship, if the process is not intelligently designed.
Let me say that a different way.
Suppose the Pentagon created such a burdensome process that vendors and contractors refused to bid on projects?
The anti competitive aspect is why we need national health care cost controls, set a price for proceedures for everyone. Todays system shafts the little guy who pays the rack rate while others pay less. Japan does this as I understand it, having an annual session to set payment rates.
I have often wondered what would happen if you said that all health care would be re-imbursed at Medicare rates, with no other option.
It seems to me that without reform of the requirements “process”, the rest is just lipstick on a pig.
The gods of test rarely appreciate realistic technological capability.
Disjoint the joint.