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?

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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