The “Experts” and Biased Articles
We are all aware of throwaway journals. We, as doctors, get them sent to us all the time. And to be honest, I do read some of them but mostly because I need fodder for this blog. I really didn’t know how bad they were until I read this article in the Family Practice News entitled New ACO model positive for physicians, experts say.
If you are like me then you would have assumed from the title that this was a study showing the benefits of ACOs to doctors. Nope. That is where the piss poor reporting comes into play. Here are the experts:
- “It’s a really good sign generally that CMS is willing and able to adapt to some of the major structural problems with the Medicare ACO model,” said Julian D. “Bo” Bobbitt Jr., a health law attorney in Raleigh, N.C. “Changing incentives to reward higher quality at lower cost and to align those is extraordinarily promising.”
- Beneficiary incentives are a key contributor to successful care management, said Larry Kocot, a health law attorney in Washington. “It’s really hard for a provider to be able to deliver coordinated care to a beneficiary if the beneficiary is not a full participant,” Mr. Kocot said in an interview. “In order for the beneficiary to be a full participant, [he or she] should for instance, be able to select [his or her] provider. This model will allow for that.”
- Dr. Patrick Conway, chief medical officer at CMS, said the next generation ACO is a response to physicians’ feedback and requests. “The ACO model responds to stakeholder requests for … greater engagement of beneficiaries; a more predictable, prospective financial model; and the flexibility to utilize additional tools to coordinate care for beneficiaries,” he said in a statement.
- The new ACO model is a likely reflection of how other accountable care organizations will be structured in the future, notes Dr. Farzad Mostashari, cofounder and CEO of Aledade, an ACO consultancy. Dr. Mostashari is the former national coordinator for health information technology. “It is a glimpse of what the whole program is going to look like in a few years’ time,” Dr. Mostashari said in an interview. “This is directionally, absolutely where the Medicare Shared Savings Program is headed.”
To summarize, two health law attorneys, a chief medical officer at CMS, and a doctor at an ACO consultancy company are the experts they are using. No biases there. Do you think they would say anything negative? Pathetic. Speaking of ACOs, where is the accountability of the magazine or the author, Alicia Gallegos? She needs to talk to doctors like me who can call out these bogus incentives and trojan horses for what they are. Crap.
And now we try to build an exciting, tech-driven version of the HMO. We pretend that Tech has overthrown the world of economics. Weee!
In truth, the ACO is now a retread of the failed HMO in which the operators strive to control costs by withholding services, occasionally subject to dire punishment from the Overseers for providing substandard care. The rules for “good care” and “bad care” are dense and vague – they essentially depend on the mood of the High Judge on that particular day. It will provide medicine MORE mystical and uninterpretable intrusion of faceless petty potentates driven by the universal principles of contempt – for the physician, for the patient, for the community.
The whole thing hinges upon our creation of a technological Wonder-Machine more appropriate in a children’s movie than in a discussion of reality. I’m reminded of…
Jeremy: What a funny noise it’s making!
Caractacus: It’s talking to us–all engines talk!
Jemima:What’s it saying?
It’s saying Chitty Bang Bang Chitty Chitty Bang Bang!
Oh you pretty Chitty Bang Bang,
Chitty Chitty Bang Bang
We love you.
Yes, the Flying Green EMR will overwhelm physics, economics and common sense, to make the HMO experiment work again. The Flying Green EMR will produce Something out of Nothing – we expect it! It is merely one small example of our century’s Ship of Fools, medical style.
Near, far, in our motor car
Oh what a happy time we’ll spend.
Bang Bang Chitty Chitty Bang Bang
Our fine four fendered friend.
Typical adminspeak with all the right buzzwords.
Interpreted as:
“We are going to hold doctor’s feet to the fire to make sure they’re not overordering tests and making our “shared savings” go down.”