Uncategorized Category

It doesn’t have to be this way. Lack of health insurance, unaffordable out-of-pocket costs, network restrictions, preauthorization requirements, penalties for readmissions, all stem from our private-insurance-based system.

  • Comments Off on To ease sickle cell suffering, enact single payer

In this comment I focus not on CMS’s costs, but the costs incurred by the FQHCs that “transformed” into “medical homes.” RAND reports that it is unable to determine what those costs are and what the “medical homes” do with the subsidies they receive from CMS.

  • Comments Off on CMS has no idea what ‘medical homes’ cost or where their subsidies go

One of the hottest new fads in managed care is “patient engagement,” aka “patient activation.” How hot? So hot Health Affairs devoted its February 2013 issue to the subject. But this fad is being sabotaged by a slightly older fad – pay-for-performance (P4P).

  • Comments Off on Pay-for-performance undermines doctor-patient relationship

NCQA’s ‘medical home’ baffles RAND

In: Uncategorized

In July the RAND Corporation released a report on the second year of CMS’s three-year “medical home” experiment with federally qualified health centers (FQHCs). The report concluded the clinics in the “medical home” arm of the experiment were spending more money than clinics in the control arm, and that this was unlikely to change by the end of Year 3. Sad to say, we’re never going to know what it was the experimental clinics did that raised their costs

  • Comments Off on NCQA’s ‘medical home’ baffles RAND

In this op-ed, Ezekiel Emanuel and his co-author admit health care inflation is heating up and accountable care organizations (ACOs) are failing to cut costs. Those are significant admissions coming from Emanuel, one of the planet’s most aggressive proponents of ACOs.

  • Comments Off on Ezekiel Emanuel admits ACOs are not cutting costs

Managed care proponents suffer from the free-lunch illusion – the illusion that the managed care interventions they support are free or, at worst, cost so little those costs can be totally ignored in reporting the alleged savings achieved by the intervention. This illusion is rarely questioned by reporters or editors of professional journals.

  • Comments Off on The free-lunch illusion feeds ACO and ‘medical home’ fads

Uncontrolled inflation of health care costs continues unimpeded as insurers, hospitals, drug companies, and others in the medical-industrial complex embrace expanded and subsidized new markets with minimal oversight. This problem is growing worse as insurers and hospitals consolidate, gain near-monopoly market shares, and raise their prices to what the traffic will bear. Meanwhile, the bureaucracy and cost of the ACA’s infrastructure continues to grow.

The annual “churn” rate among Medicare accountable care organization (ACO) doctors and assigned patients is enormous: It averages around one-third for both doctors and patients. Because of this constant doctor and patient turnover, ACOs lose the majority of their assigned patients over a five-year period. How is an ACO supposed to be held “accountable” for services given to such a rapidly changing panel of patients by such a rapidly changing roster of physicians?

  • Comments Off on Patient turnover in ACOs destroys accountability

CMS’s latest ACO report is inscrutable

In: Uncategorized

Stuart Guterman’s characterization of CMS’s latest report on the Pioneer ACO program is accurate. It is impossible to explain the report’s findings.

  • Comments Off on CMS’s latest ACO report is inscrutable

The Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) are violating a fundamental rule of science: They are soft-pedaling the disappointing financial results of the Pioneer ACO program and trumpeting the results of a simulation of the program.

  • Comments Off on CMS studies simulated model of ACOs and claims great savings

About this blog

Physicians for a National Health Program's blog serves to facilitate communication among physicians and the public. The views presented on this blog are those of the individual authors and do not necessarily represent the views of PNHP.

News from activists

PNHP Chapters and Activists are invited to post news of their recent speaking engagements, events, Congressional visits and other activities on PNHP’s blog in the “News from Activists” section.