More ACO Propaganda


You always have to be careful about what you read because everyone has their own biases.  Even this blog is slanted my way because, well, that’s the way I want it.  If you have been reading my stuff for any amount of time, you would have realized that I am biased towards doctors and nurses and against big gov’t, insurers, administrators and so on. I admit it.  That being said, when bogus sites like HealthLeaders Media puts out an article entitled Anthem Blue Cross ACO Generates Savings of $8 Million, I immediately become suspicious.  Please read it because the assumption is that the ACO concept is working beautifully. Here are some highlights:

  • By focusing on members who have two or more chronic conditions, an Anthem Blue Cross ACO in California has been able to save almost $8 million by reducing incidences of hospital stays and outpatient visits, and increasing the use of generic prescription drugs.
  • The results were generated by approximately 200,000 participants during a one-year period from July 2013 to June 2014. The goal was to better coordinate care so that patients would better manage their conditions and improve their overall health.
  • Participants reported a 7.3% decline in hospital admissions per 1,000 patients, a 2.3% decline in outpatient visits per 1,000 patients, and a 4.2% increase in the use of generic prescription drugs. While 19 medical groups are taking part in the Enhanced Personal Health Care Program, the $7.9 million in savings was reported by six medical groups who started their programs around the same time.
  • Gerald Kominski, director of the UCLA Center for Health Policy Research, said the results reported by Anthem are a sign that value-based care can produce results. “I find the results encouraging because they showed reductions in hospital IP [inpatient] days and stays, the most expensive component of care,” said Kominski. “These are system changes that are long overdue, in my opinion, and indicate that healthcare providers are moving at a faster rate to adopt value-based care.”

Sounds awesome, right?  Well, $8 million divided by 200,000 is a savings of $40 per patient. I pay $13,000 a year for my Anthem policy.  I am not sure if I paid $12,960 that I would notice.  But let’s say this is a major amount of savings.  Great.  Then were is that money going?  To the doctors?  Back to the patients?  It doesn’t say.  And how much time and money did it cost these participating physicians to create these savings?  It doesn’t say.  Well, it sure would have been nice to have this information.

This is a typical media fluff piece.  No hard questions.  It’s just propaganda to be fed to the masses.  The Authentic Medicine website is devoted to questioning authority because accepting bullshit, like this article, as fact only causes more problems in the long run.

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