An earlier post explained the portion of Obamacare that creates Accountable Care Organizations, or ACO’s. They are essentially a group of doctors and hospitals and testing services that would form one business entity to take care of all of the medical needs of “assigned beneficiaries”. In Obamacarespeak, a “beneficiary” is someone on Medicare. The “assigned” part is still a mystery.
In early April, the Department of Health and Human Services issued it’s draft regulations covering ACO’s. Although the comment period for proposed regulations is still open, the early results are not encouraging.
…in an unusual rebuke, an umbrella group representing premier organizations such as the Mayo Clinic wrote the administration…saying that more than 90 percent of its members would not participate, because the rules as written are so onerous it would be nearly impossible for them to succeed.
A little bit of information on this “umbrella group”. It is the American Medical Group Association. Other than the Mayo Clinic, it,
represents nearly 400 large medical groups around the country providing care for roughly 1 in 3 Americans. Its members, including the Cleveland Clinic, Intermountain Healthcare in Utah, and Geisinger Health System in Pennsylvania, had been seen as the vanguard for accountable care. [emphasis supplied]
And, here is the problem.
The medical groups say they are worried they will be left holding the bag for losses, that the government has designed things so there is no easy way to tell which patients are part of the program [I think this is the "assigned" part], and that there’s no reliable way to adjust for patients who are sicker and require closer follow-up and more expensive treatments.
This is somewhat problematical for the administration which had anticipated some $960 million in savings over the first 3 years from ACO’s. And, as you may recall,
[m]any in the health care industry were silent partners backing Obama’s overhaul law, but disappointment over the accountable care rules has put a chill into the relationship. During the congressional debate, Obama extolled Mayo and Geisinger, holding them up as a model of what he wanted to achieve for the nation. Industry criticism of his administration’s proposal has been building up for weeks in online forums.
So, another piece of Obamacare (see: waivers) is falling flat on its face.
Bottom line…the government has no earthly idea how to run a business. This administration wants to regulate how things “should be”, without any understanding of how things “are”.