This is a different version from what we hear in the news but if you read through all of it Rosch may have some very good points.  Right now hospitals rely on payments from commercial carriers (which those get nibbled at too) to make up for the losses for both Medicare and non insured patients and his thoughts seem to carry right on imagethrough for the Medicare portion of this with ACOs.  Granted there is always room for improvement here but again, what is an ACO?  There’s no real standards for them as they differ from each situation.  Everyone thinks they need one but going about it is is lot different.

ACOs cannot exist without Health IT investments, big ones and sometimes are those investments, many of which will be needed in time make a difference or are we moving money from one till into another?  Of course all the Health IT consultants will tell you have have to have it right now…and there may be some truth to that in needing at least a part of it, but how about those hospitals even with stimulus money that are having a hard time financially.  ICD10 estimates have been found to be way off and as much as 10 times more than estimated. 

Will Healthcare ACO Incentives Be Consumed by Software and Vendor Expenses When It’s All Said and Done?

Nothing moves without software and “those algorithms”.  The Cleveland Clinic CEO wants changes to the current rules too, so along with Meaningful Use phase one and two, ICD10 and a few other Health IT goodies in there today, is this worth pursuing?  BD

Cleveland Clinic CEO Recommends Changes to Current ACO Rules

U.S. Federal Trade Commissioner J.Thomas Rosch slammed the accountable care organizations instituted by ObamaCare at an antitrust conference yesterday, saying that Medicare cost savings would actually lead to higher overall costs and lower quality patient care.

The ACO initiative aims to shift the business of health care delivery from a fee-for-service model to one that pays hospitals and care providers based on quality of care, coordination of care and cost-effectiveness. It's slated to kick off on a voluntary basis next year.

In his speech, titled "Accountable Care Organizations: What Exactly are We Getting," Rosch said that while the idea of using financial incentives to reduce costs and improve quality of care is a good one, he's skeptical that ACOs will lead to any net savings. In other words, even under the most optimistic scenario, the savings to Medicare from the ACO program are no more than a rounding error," said Rosch.

Rosch warned the antitrust conference attendees that any reduction in costs from a shared savings program would likely be borne by commercial payers and result in lower quality patient care.

In an opinion piece published on the Health Affairs blog earlier this year, industry lobby AdvaMed president & CEO Stephen Ubl wrote that the ACO program "is the right treatment to fix the ills of our nation’s health system," but cautioned that it runs a "real danger of stinting on care" for Medicare patients.


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