Those selling software in the Health IT business are the only winners here.  Patients don’t even know if they are in one and much less what one is.  The initial savings for an ACO might show promise but what do you do once you hit the first year or two? 

A new model is needed here or maybe new terminology.  We tried it, some saving but when you figure all the hoops, the extra reporting required, is there really any savings at the bottom line?  I don’t think so from what I have read and I think we just got soakedimage in software overall.  Sure the idea was good when created but within the last couple of years, models are not working anymore. 

Like most of the failing models in healthcare, there’s way too much over quantitation and in some area too much focus on non relevant data that does not end up showing an ROI.  We need actionable software that makes us efficient as well. 

The next one after this to fail will be over quantitated population health.  If population health is done in moderation and finding facts that can be helpful, that’s fine and it should be used like a registry to find out how you are doing with quality and managing.  However, we have some folks going off the deep end here again as what’s been done in many areas of healthcare.  I’m not talking about genomics and scientific research as that is what they do but we don’t need all of that with over stuffed analytics to run the every day business of healthcare and that’s where developers with their proofs of concepts are going, they don’t know where to stop.

Why do you think everyone is complaining about EMRs?  It’s the same reason and we need a balance of actionable workflow software that helps us do a better job, and yet not bog us down.  I like smart technologies and data that helps but we seem to be in this race to get down the last grain of rice with managing care.  Again in science and genomics, they after the last grain of rice but in the business side of taking care of patients, we are over whelmed. 

Every day several headlines “this hospital or insurer formed an ACO” and the next day another one.  All we need to do is look at the pilot program from Medicare to see that the models are not working and thus so you can’t have a one size fits all, why?  Because it’s the people business and there needs to be a balance that we don’t have right now.  I really could go months without seeing another press release on someone starting an ACO:)  At the link below, hospitals in Ohio, are basically saying “models are broken” in reference to Medicare reporting. 

Antiquated Ways Hospitals Report Cost to Medicare “Really Distorts” The True Cost of Care–New Model Please..

Let’s get rid of the analytics and glut we don’t need for taking care of patients and focus on work flow and actionable data.  If you don’t watch it closely, software builds on itself over and over and soon you end up with a mess of this progression and people get irritated as the complexities grow too. 

A $372 million dollar savings for Medicare with the dollars they spend and manage is like peanuts when you reference their pilot programs.  I’ve seen ACOs too where they just come in and slash reimbursements too or have a complex formula there too.  Then there’s the bundled care model, it made my head spin reading it.  We can have models that work but building on to a model that is already failing is not the answer to fix it.  Ask the financial folks on that one and they can tell you. 

The Four Models of Bundled Care - 3 Year CMS Algorithmic Patient Care Improvement Initiative, Yet One More Model To Enrich Health IT Profits With Complexities, Variables Will Kill This Model In Time…

Again we have a complex monster here that will continue in that direction and the results seen are not worth the time.  Sure there’s things folks learned how to do better but they would have probably done that anyway, ACO or not as hospitals are always increasing efficiencies in some way or another.  All the hype on big data makes you think need big data when in fact you really don’t all the time.  We have a data addiction problem that’s not producing real ROIs.  What I said a couple years ago and it seems true today. 

Half of Analytics Investments By Companies and Banks Will Be a Waste–What Do We Analyze with Big Data and Does It Have Value–Some Algo Fairies Would Do Better at Disneyland…

So let’s kill this model and make reporting and quality issues easier so we get back to patient care as the focus.  If you want to save the name ACO, be my guest but let’s begin simplifying things so we can co-exist with realistic goals.  We already have complex items we can’t fix or change in the way of coding with the new ICD 10 that’s coming in so you can’t keep adding more complexities to the model and expect good results when it’s in failing mode as the start.  BD 


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