Sunday, September 13, 2015

Strip Tease of ACO Bureaucratese

This is a strip tease act to reduce federal bureaucratese to its bare essentials.

Six Medicare professional just wrote this explanation of why physicians should participate in Accountable Care Organizations:
“Earlier this year, the Department of Health and Human Services announced the goals of tying 30% of Medicare payments to alternative payment models by the end of 2016 and 50% by the end of 2018. That move was reinforced by the Medicare Access and CHIP Reauthorization Act of 2015, which replaced the sustainable growth rate formula for calculating physician payments with a Merit-based Incentive Payment System (MIPS) that consolidates and incorporates key components of the Physician Quality Reporting System, the Physician Value-Based Payment Modifier and the Medicare Electronic Health Records Incentive program for eligible professionals. The MIPS will adjust payment rate on the basis of physicians’ performance on quality measures, resource use, clinical practice improvement activities, and meaningful use of electronic health records. Eligible professionals participating in eligible alternative payment models could receive a 5% lump-sum payment each year from 2019 to 2024. If they meet program criteria, accountable care organizations (ACOs) could thus be central to Medicare’s strategy for delivery-system reform.” (“Medicare’s Vision for Delivery-System Reform – The Role of ACOs,” New England Journal of Medicine, September 10, 2015),

Translated and stripped of its programmatic gobbledygook, this means Medicare will offer 5% bribes to physicians if they agree to participate in an ACO, 423 of which now dot the healthcare landscape. If physicians (pardon “physician practices, Independent Practice Associations (IPAs), health systems, hospital-physician partnerships , or any or all of the above act in partnership with other partnering health care facilities” agree to do so, they will become “partners” with the federal government’s Medicare program.
This presumably is a deal physicians cannot refuse. All you have to do is to give up your autonomy and freedom to practice as you’ve been trained and accustomed to doing is to serve as a serf of government. Welcome Aboard, Partner!

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