This isn't good for Obamacare....... Some of the hospital groups allied with Pioneer ACOs are some of the largest in the country. The quality metrics demanded by Obamacare, as well as the imopssibly high benchmarks doomed this from the beginning.
Nearly one-third of 'Pioneer' ACOs may opt out
Some of the organizations may join Shared Savings Program instead
July 01, 2013
Nine of the 32 "Pioneer" accountable care organizations (ACOs) may soon exit the program, which is one of the Affordable Care Act's signature initiatives to pilot better care at lower cost, Alex Wayne reports at Bloomberg Businessweek.
Long-simmering concerns
Under the Pioneer program, which launched in January 2012, participating providers contracted with CMS to meet quality targets and assume new risk when caring for a set population of Medicare beneficiaries; in exchange, they received additional financial incentives.
However, most of the Pioneer ACOs threatened in March to drop out of the program unless CMS updated its measures for performance and pay. While CMS eventually agreed to make some changes to data tracking and dissemination, it reiterated that it would begin linking the Pioneers' incentives to their quality performance this year, rejecting the program participants' request to delay.
At least four of the organizations that are opting out of Pioneer instead may join the Medicare Shared Savings Program, which offers less risk, according to a CMS spokesperson.
The decision by some organizations to leave the program is a "potential threat to the Affordable Care Act’s ambitious cost-saving goals," Wayne writes. Specifically, providers' willingness to opt out of the Pioneer program could "really sho[w] a critical cost-containment approach in the Affordable Care Act is running into real problems," according to Robert Blendon, a health-policy professor at Harvard University’s School of Public Health.
Blendon suggested that participants may be learning that the added risk of managing care for chronically ill patients is more difficult than they anticipated (Evans, Modern Healthcare, 6/28 [subscription required]; Wayne, Bloomberg Businessweek, 6/28).
One third of Pioneer ACOs to drop out of
Moderator: Super Moderators
Obamacare? We were just leaving …
By: Anna Palmer and Jake Sherman
June 13, 2013 05:13 AM EDT
By: Anna Palmer and Jake Sherman
June 13, 2013 05:13 AM EDT
Dozens of lawmakers and aides are so afraid that their health insurance premiums will skyrocket next year thanks to Obamacare that they are thinking about retiring early or just quitting.
The fear: Government-subsidized premiums will disappear at the end of the year under a provision in the health care law that nudges aides and lawmakers onto the government health care exchanges, which could make their benefits exorbitantly expensive.
Democratic and Republican leaders are taking the issue seriously, but first they need more specifics from the Office of Personnel Management on how the new rule should take effect — a decision that Capitol Hill sources expect by fall, at the latest. The administration has clammed up in advance of a ruling, sources on both sides of the aisle said.
If the issue isn’t resolved, and massive numbers of lawmakers and aides bolt, many on Capitol Hill fear it could lead to a brain drain just as Congress tackles a slew of weighty issues — like fights over the Tax Code and immigration reform.
The problem is far more acute in the House, where lawmakers and aides are generally younger and less wealthy. Sources said several aides have already given lawmakers notice that they’ll be leaving over concerns about Obamacare. Republican and Democratic lawmakers said the chatter about retiring now, to remain on the current health care plan, is constant.
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Cherry Kelly
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Lore wrote: Obamacare? We were just leaving …
By: Anna Palmer and Jake Sherman
June 13, 2013 05:13 AM EDT
Hold the phone - I thought Lawmakers were exempt from this debacle??????
Did I miss something?
A man's character is his fate
Lore wrote: It seems that after a certain amount of time, even those in charge will be a part of this mess.
I guess it depends on how well "connected" they are. The more I look at American politics, the more I noticed that our Congress is much like Parliament - you have the House of Lords (US Senate) and the House of Commons (US House). Both are far above the everyday American's income levels that they can't evenrelate, but, more so the Senate. They remind me frequently that they think of themselves as little lordlings.
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Cherry Kelly
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Nice. So only employers get a pass on paying penalties for now, while otherwise uncovered unfortunates at the bottom still have to abide by the individual mandate or get dinged - In any way how is that fair? Businesses get vital breathing room to adapt, those below remain in an enclosed sufficating space sans similar relief of any sort?Cherry Kelly wrote: ...and now Obama is going to postpone the EMPLOYER mandate until
AFTER THE 2014 ELECTIONS!! 18
Some swell pyramid scheme. It's Amway or the highway.
Affordable Health Care Act - in reality not affordable, and cumbersome and convoluted as hell. Those who grasped it early went right for the waivers and got them.
As we inched up toward 1/1/2014 brokers, brokerage firms, carriers and everyone else charge with educating the folks who were saddled with this started educating the folks. When the folks (large employers, those with 50 and over employees, finally got it because they had to as it was looming, those with influence started screaming like stuck pigs and they bent the ear of their elected officials and that is when the idiots who pushed this to begin with finally started comprehending how the bill worked and when that happened they knew they could not get re-elected in 2014.
Boehner was right about one thing- this is a train wreck.
Folks like Kbot who work in the health field and others of us affiliated with the health field got it early on.
The money which carriers and all those affiliated have expended just to get ready for this boondoggle is out of sight.
So Obama who is truly a man of the people, in the end sticks the little people with his dream bill and lets big business off the hook -for now.
Now finally we have some real transparency.
As we inched up toward 1/1/2014 brokers, brokerage firms, carriers and everyone else charge with educating the folks who were saddled with this started educating the folks. When the folks (large employers, those with 50 and over employees, finally got it because they had to as it was looming, those with influence started screaming like stuck pigs and they bent the ear of their elected officials and that is when the idiots who pushed this to begin with finally started comprehending how the bill worked and when that happened they knew they could not get re-elected in 2014.
Boehner was right about one thing- this is a train wreck.
Folks like Kbot who work in the health field and others of us affiliated with the health field got it early on.
The money which carriers and all those affiliated have expended just to get ready for this boondoggle is out of sight.
So Obama who is truly a man of the people, in the end sticks the little people with his dream bill and lets big business off the hook -for now.
Now finally we have some real transparency.
A man's character is his fate
The budget deficit associated with this, will cause the entire budget deficit to swell further into the trillions before 2020, from what I've read.
In order to maintain compliance, healthcare organizations have been required to switch over from paper to electronic medical records. Granted, there has been assistance from the federal government with billions of dollars at stake.
One result? Many healthcare providers have opted to move away from facility-owned servers for their archiving, and move their electronic medical records to the cloud.
Early projections are that the costs for maintaining archives is currently low, but the consensus is that with licensing fees, watch for the maintenance of these archives to skyrocket in a few years.
Just another thing that will drive up the costs of healthcare.
One thing we HAD going for us - when the computers go down, we could always resort to paper. Now, what we find is that, when the computers go down, we (and the patient)- are screwed.
As the saying goes - "Be careful what you wish for, you may just get it." Maybe not the WAY you wanted, or envisioned.......
In order to maintain compliance, healthcare organizations have been required to switch over from paper to electronic medical records. Granted, there has been assistance from the federal government with billions of dollars at stake.
One result? Many healthcare providers have opted to move away from facility-owned servers for their archiving, and move their electronic medical records to the cloud.
Early projections are that the costs for maintaining archives is currently low, but the consensus is that with licensing fees, watch for the maintenance of these archives to skyrocket in a few years.
Just another thing that will drive up the costs of healthcare.
One thing we HAD going for us - when the computers go down, we could always resort to paper. Now, what we find is that, when the computers go down, we (and the patient)- are screwed.
As the saying goes - "Be careful what you wish for, you may just get it." Maybe not the WAY you wanted, or envisioned.......