Higher Costs, Less Quality for ACOs?


There is a great article in Modern Healthcare that I want to share with you.  The title is called Many private-payer ACOs fail to yield lower costs, better quality.  The whole thing is filled with excuses.  Because of the failure of this concept the administrators have come armed with tons of sound bites ready to be spit out at a moment’s notice. Check out a few from the article:

  • Their experiences reflect that ACOs are still a new structure, and building a new payment and care model as complex as an ACO is not easy to roll out.
  • Our alternative payment models are succeeding at a much lower rate than they should be,
  • Part of the problem, he said, is that so many doctors are still paid on a volume basis. Successful ACOs have tied payment to measures of quality, safety and patient satisfaction—and hospitals and doctors were on board with that.
  • “When we drill down into what’s driving that, it appears unless the groups have aligned their physician compensation system to the incentives, you’re not going to get the results,” Muney said.
  • Most of the time, patients are not even aware they are part of an ACO, Ondra said.
  • “What’s missing is the consumer and the experience they have,” he said. “Very few will have a clue they are in those kinds of arrangements. That creates a tremendous gap.”
  • The physician executives said although some ACOs have flopped thus far, they still like the strategy overall. Each insurer has more ACO deals in the pipeline, and they’re trying to improve the model for patients. “It’s a learning process,” Popiel said.

Can’t you see what they are doing?  It is deflection to keep this crappy concept alive.   It can’t be that the ACO concept is just smoking turd.  No, it is that the concept is too new or that it is the doctors’ fault for not buying in or its even the patients’ fault!

We need to kill the ACOs.  They will never work.  It is a just a new game created so hospital groups can eventually figure out how to beat and then the rules will be changed again.  This is just a another example of industrialized medicine and it is a failure.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]

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