Gambling For Better Bonuses

More and more Medicare Accountable Organizations are “taking on upside and downside risk under CMS’ Medicare Shared Savings Program and Next Generation ACO Model.”  That’s interesting.   You have to love a healthcare model  that pressures large organizations of doctors to take bigger risks with unproven metrics.  Here’s more:

  • The two-sided risk allows participants to receive bonuses if a certain outcome is met or face penalties if costs are higher than a specific benchmark.

So, what is the problem with this?  Well, for one, if forces doctors to focus more on the metrics being measured by Medicare while ignoring those not being measured.  That is human nature.   Secondly, it forces doctors to prescribe more medications to bring those numbers down so their metrics look better.  That means more statins, more high blood pressure drugs and more diabetic medications.  In deference to David Farragut, “Damn the side effects, full speed ahead!” (And yes, I know the irony that his last name is close to mine).

This is called “teaching to the test” and it is bastardized medicine.  Where is the purity of our job?

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