Population Health is part of an Accountable Care Organization and when used properly without folks going off the cliff analytics it can work well.  We don’t see enough of this out there.  Also below is a video to where the Doctor’s group runs the ACO and not an insurance company. It gives a very realistic approach and there’s not big pay for performance hanging over anyone’simage head either.  Again in my opinion, I think peer pressure is enough as when big dollars with P4P come into the picture, so does the tendency to cheat a bit.  We have seen that and most doctors are in the business to provide good care as that’s their profession. 

Where population health gets distorted is when you have the over zealous folks that want to go further and dig even deeper with patient information as we all read with the idiotic hospital thinking they needed to have all the patient MasterCard data on file.  You have to treat people with dignity and I’m sorry that’s not dignity but rather more of “control” situation to where one thinks if “I have all this data I’m going run out and get into the face of those patients” and what happens next?  We resent it.  You do have bone head executives that think this is the answer to “get the data on the patients and then roll out the Spanish Inquisition”:)  Read the link below for how that thinking works and realize that this is someone who doesn’t believe in dignity if you will.  Education is always best. 

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What ends up occurring in situations as such as spelled out in the link above is patients and consumers start heading for the exit doors and work to stay outside the radar and then the whole concept doesn’t work anymore as the algorithmic chase is on and nobody likes that at all.  It’s all about money when you go to those extremes too.   Because of the incentives to make money people try to rationalize care with no dignity and it just won’t work very well when money takes the place of dignity.  I just think some of the folks are just flat assholes at times when I read some of what’s in the news with quantitated justifications for things that are not true.   Insurance companies can act like assholes too on occasions with little thought for dignity. 

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See here’s another example of the extremes being explored in New England too with patient data, and again we as patients will hate your for it as you strip our dignity.

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But back on target here Dr. Biggs who I have known for a few years now does a great job with his explanation of how their ACO works and his group is physician run versus an insurance company and we all know when insurers run an ACO, well watch out for the analytics as they are going to be geared first off the foremost for profit as shareholder interest really comes before patient care, and we all know that and it’s not hard to figure out as all you have to do is read the news and watch their behaviors, it’ no secret.  In Dr. Biggs group you don’t have that and he shows some modest savings but more so it’s the working together for better care that comes through in this video and not some pay for performance nonsense, which is the way it should be.  The group has been through their challenges as I remember I think it was a couple years ago they lost Blue Cross as an insurer and that may be changed by now as well but they held their ground at the time. 

So again it’s nice to hear about an ACO and population health program with analytics that are being used with common sense and at the same time still giving patients the dignity they need as well as the care.  By comparison I watch the big United Healthcare owned Monarch IPA in the OC with their ACO and there’s no comparison as I hear complaints all the time about it with doctors in that group getting paid at rates less than Medicare in order to participate and is that a real ACO?  Of course too we know that insurers are buying up and selling our data like crazy and also they purchase patient credit card records (as MasterCard makes big money from insurers for our data) and analyze your voice with call centers too, so like yeah, where’s the trust there with an insurer running an ACO and also owning the doctors group?   Consumer are also getting leery of using insurer apps too as we all know they capture and mine that data too and who knows where it will show up to “score” us down the road. 

Would it be nice if all ACOs could work like what Dr. Biggs is doing with his group? 

He also told me he uses the eClinicalworks HEALOW phone app to communicate with patients and this app has privacy and there’s no consumer data grabbing going on with the app at all, thus patients keep their dignity, they engage and it all works.   This is what can be done with a doctor’s group with no health insurance intrusion which is really a goo thing.   BD



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