"Over the weekend, Bloomberg reported on the latest challenge to Obamacare: hospitals leaving one of the law’s signature attempts to contain health costs," w
rites James Kidd on Heritage.org.
He quotes from a piece on Bloomberg.com:
Almost a third of 32 hospitals and health systems involved in an experiment aimed at changing the way medical providers are paid may exit the program, a potential threat to [Obamacare’s] ambitious cost-saving goals.
While reminding readers of then-candidate Obama's promise that if you like your health care, nothing will change (except it becoming less expensive), Kidd adds
One of the reasons hospitals are leaving the ACO program involves government red tape. In order to manage their patients most effectively, hospital systems want access to real-time medical claims data—but Medicare’s lumbering bureaucracy can provide information on health claims six months after the fact. As the CEO of one hospital organization told Bloomberg, “We’re asking for more agility than the system is really set up to produce.”
The other reason for the ongoing ACO struggles centers around the euphemistically termed “clinical control”—in other words, patients’ ability to see the doctor they want. The Bloomberg article notes that right now, hospitals in the ACO program “can’t forbid the patients from seeing doctors or other health providers who aren’t part of the Pioneer system.” Hospitals believe this restriction on their ability to manage patients has prevented them from containing costs as much as originally hoped.
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