Medicare Data Show Wide Differences In ACOs’ Patient Care

By Jordan Rau
Kaiser Health News, February 21, 2014

Networks of doctors and hospitals set up under the Affordable Care Act to improve patients’ health and save money for Medicare are having varying rates of success in addressing their patients’ diabetes and heart disease, according to government data released Friday.

About 4 million Medicare beneficiaries are being cared for by one of the more than 250 ACOs that Medicare has approved. Each ACO is responsible for taking care of a group of at least 5,000 Medicare beneficiaries; although patients can go to any doctor they choose. Medicare counts as part of an ACO the patients who mostly go to doctors and facilities within that coalition. Patients generally do not choose an ACO.

The release is the first public numbers from Medicare of how patient care is being affected by specific networks. These accountable care organizations, or ACOs, are among the most prominent of Medicare’s experiments in changing the ways physicians and health care facilities work together and are paid.

To make sure the ACOs are not stinting on care in their quests to earn bonuses, Medicare is tracking 33 different quality measures.

On Friday, the Centers for Medicare & Medicaid Services (CMS) released data on five of these measures for 141 ACOs during 2012. Four evaluate how well the ACOs helped patients with diabetes. The fifth examined how many patients with arteries packed with plaque received appropriate medicines to relax their blood vessels. Medicare said it did not release more measures because it did not think some of them could be easily understood by consumers or would be useful. Other measures, such as ones about cholesterol levels, were not released because the clinical standards have changed.…

Single payer reform continues to be dismissed in favor of insurer-friendly reform – reform led by accountable care organizations (ACOs) initiated by the Affordable Care Act (ACA). This new report should make it clear that we are following the wrong path.

Of tens or hundreds of thousands of potential measurements to determine quality, only thirty-three were selected. Of those thirty-three, only five are being reported because the other twenty-seven were not useful, or could not be understood, or were measuring out-of-date standards.

It is an outrage that our government continues to take us down this expensive ACA pathway that wastes our resources while impairing access for far too many people with health care needs. They keep promising us that ACOs will improve efficiency and quality, when they have already proven otherwise. Five lousy measures! Is that all that we have to show for it!?

We need to dismiss our politicians and have them take with them their ACA with its ACOs so that we can bring in leaders who will establish for us a truly American program – an improved Medicare single payer program that covers everyone.

Five measurements, and four of them are for only one disease! Get outta here!