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.
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?
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.
Oh good grief. Just another cockamamie government “initiative “
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.
The only train wreck ever recorded that kept moving forward years later.
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.