May 3rd, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
1 Comment »
Thousands of articles have been written about forming ACOs. Millions of dollars have been spent by hospital systems to try to form an ACO. Healthcare policy consultants have discovered a new cash cow.
Hospitals systems are wasting their money. They think the return from owning salaried physicians’ intellectual property will be more than worth the cost.
- Thousands of physicians have been confused by the concept of ACO.
- Many have felt ACOs are an attack on their freedom to practice medicine the best they can.
- Many have rejected the concept because they feel they will have to be salaried by hospital systems.
- Many physicians do not trust President Obama or Dr. Don Berwick.
- The Stage 2 ACO regulations are not easy to understand. They are more ominous than the stage 1 regulations.
The two core stated objectives for ACOs are:
(1) Reducing healthcare costs.
(2) Preserving and improving quality.
The stated objectives are laudable. The government regulations and controls are confusing. Read more »
*This blog post was originally published at Repairing the Healthcare System*
May 3rd, 2011 by DavidHarlow in News, True Stories
No Comments »
In recent years many health care providers and managers have told me, time and again, that the health care world is accustomed to managing confidential patient information, and therefore doesn’t need much in the way of social media training and policy development. This week brings news that should make those folks sit up and take notice. A physician in Rhode Island, who was fired for a Facebook faux pas, has now been fined by the state medical board as well. The physician posted a little too much information on Facebook — information about a patient that, combined with other publicly available information, allowed third parties to identify the patient. The details of the story are available here and here.
The key takeaway from this story — and the Johnny-come-lately approach to health care social media taken by the Rhode Island hospital in question and the Boston teaching hospital that the Boston Globe turned to for comment — is that prevention is the best medicine. Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
April 20th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
No Comments »
In 2009 President Obama stated that Accountable Care Organizations (ACOs) were going to be pilot programs in real world settings. The goal was to see if they effective in reducing costs and increasing “quality of care.” The results of the pilot programs have not been published.
Last week despite the lack of proof of concept HHS and CMS announced new proposed regulations for ACOs.
The new delivery and payment model the agency estimates could serve up to 5 million Medicare beneficiaries through participating providers, and also potentially save the Medicare program as much as $960 million over three years.
How were these estimates derived? It could be another accounting trick by President Obama’s administration.
The idea of coordinating care and developing systems of care is a great idea theoretically. From a practical standpoint, execution is very difficult.
I tried to execute something similar in 1996 with the American Association of Clinical Endocrinologists; a national Independent Practice Association. AACECare received little cooperation or interest from Clinical Endocrinologists.
The problem is coordinated medical care is dependent on physicians cooperating and not competing with each other. It also depends on hospital systems developing an equitable partnership with physicians.
The equitable partnerships between hospital systems and physicians are difficult to achieve if past results are any indication of future results. Read more »
*This blog post was originally published at Repairing the Healthcare System*
April 17th, 2011 by Linda Burke-Galloway, M.D. in True Stories
No Comments »
Olympic winner and motivational speaker, Jim Stovall once said “Integrity is doing the right thing, even when no one is looking.” In September 2009, I wrote about a blog about Carolyn Savage, a 40 year old woman with a poor obstetrical history. Savage married her college sweetheart and had an uncomplicated first pregnancy. However, her second child was born prematurely. She had 4 subsequent miscarriages and ten years later she became pregnant through in-vitro fertilization (IVF). Because the Savages wanted a large family, they tried IVF again. Unfortunately, Savage was impregnated with the wrong embryo. To their credit, everyone rose to the highest level of integrity. The infertility clinic informed the Savage family as soon as the mistake was discovered and then gave them the option of terminating the pregnancy or continuing it. The Savage family then had to inform the rightful parents of the embryo that were not expecting to have a baby any time soon but was now faced with that dilemma. Savage ultimately delivered the baby and then handed it over to its rightful parent, the Morrell family. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
April 12th, 2011 by Michael Kirsch, M.D. in Health Policy, Opinion
No Comments »
Prototype ‘BS’ meter.
So many folks express views that are obviously self-serving, but they try to masquerade them as altruistic positions that benefit some other constituency. These attempts usually fool no one, but yet these performances are common and ongoing. They are potent fertilizer for cynicism.
Teachers’ unions have been performing for us for decades. Their positions on charter schools, school vouchers, merit pay and the tenure system are clear examples of professional advocacy to protect teachers’ jobs and benefits; yet the stated reasons are to protect our kids. Yeah, right. While our kids are not receiving a top flight education, the public has gotten smart in a hurry on what’s really needed to reform our public educational system. This is why these unions are now retreating and regrouping, grudgingly ‘welcoming’ some reform proposals that have been on the table for decades. This was no epiphany on their part. They were exposed and vulnerable. They wisely sensed that the public lost faith in their arguments and was turning against them. Once the public walked away, or became adversaries, established and entrenched teachers’ union views and policies would be aggressively targeted. Those of us in the medical profession have learned the risk of alienating the public. Teachers have been smarter than we were.
The medical profession is full of ‘performances’ where the stated view is mere camouflage. For example, Read more »
*This blog post was originally published at MD Whistleblower*
