The Value Journey

I found this article in Health Affairs interesting. It’s called Recent Progress In The Value Journey: Growth Of ACOs And Value-Based Payment Models In 2018. Isn’t the term “Value Journey” soothing and reassuring?  Brilliant.  It’s like a train tour of Europe or a trip to the Himalayas to find the meaning of life. Unfortunately, it is nothing like that.  This ACO and Value-Based Payment crap, without evidence, is moving ahead at full-speed.  Here are the highlights from the article:

  • …private payers continued to highlight their commitment to value-based care.
  • We find that, despite the past year’s uncertainty around federal policies and the future of value-based care, the health care system continues to adopt new payment and delivery models.
  • Driven primarily by growth in Medicare ACO programs, the overall numbers of ACOs and ACO contracts continued to increase through the first quarter of 2018.
  • The question is no longer whether CMS will proceed with VBP, but rather what form it will take.
  • Judging from public statements by CMS and others in the administration, the major changes will likely focus on transitioning ACOs from one-sided risk (shared savings only) toward meaningful two-sided risk (shared savings and losses) as they remain in the program for longer.

Well, it’s “all aboard” the Value Train as we take our journey into Failure Land. I am your conductor and, on the right, you will see doctors quitting or committing suicide.  On the left, you will see patients lining up and waiting to see the doctors who are leaving.   Coming up is Misery Valley where all that is left of the healthcare system is administrators and anyone who they can pay cheaply enough to pretend to be doctors.

Enjoy the view.

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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] 

  6 comments for “The Value Journey

  1. Robert Riley
    August 17, 2018 at 6:07 pm

    I guess declaring something “value based” confers some sort of value. So, for over forty years, I have been harboring the delusion that my profession values evidence, as in evidence based medicine. Along comes ehr/emr, moc, and endless government mandates. Who needs evidence?

  2. Steve O'
    August 15, 2018 at 9:16 pm

    There are several useful ways to dominate and suppress any group of people. One is to make them frightened and insecure about what constitutes quality and value.

  3. Mamadoc
    August 15, 2018 at 2:12 pm

    Oh good grief. Just another cockamamie government “initiative “

  4. RSW
    August 15, 2018 at 1:31 pm

    And every medical society is acting as conductor, telling us to hurry up and get on board so we can all go over the cliff together.

  5. Pat
    August 15, 2018 at 12:46 pm

    The only train wreck ever recorded that kept moving forward years later.

  6. PW
    August 15, 2018 at 10:42 am

    I’ll take the Midnight Train to Georgia, the Last Train to Clarksville, the Orient Express, the Orange Blossom Special, the Wabash Cannonball, but I ain’t taking no stinking Value Journey.

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