Tuesday, September 06, 2011

Accountable care organizations: managed care on steroids

Accountable care organizations (ACOs) are being touted by policy elitists as the way to integrate health care services, improve quality and reduce costs. To many in the trenches of health care who have experienced the law of unintended consequences this view is naïve. We know that more intrusion from government means more conflicts and more pressure to game the system. According to this Pajamas Media piece by Paul Hsieh ACOs will merely bring new and more perverse cost incentives leading to cherry picking of patients along with new and creative ways to abuse the system:

Less scrupulous providers will thus be tempted to manipulate the assignment rules to avoid these burdensome “ACO lepers.” Consulting firms are already advising prospective ACOs on the pros and cons of various patient assignment systems. Because the financial stakes are so high, some will inevitably seek to exploit these rules to their advantage, even if it’s at their patients’ expense...

Under ObamaCare, the winners will be those lobbyists, consultants, and less-scrupulous hospitals and doctors willing to “game” the system to their advantage. The losers will be those doctors unwilling to play those games — and their patients.

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