[xtypo_dropcap]T[/xtypo_dropcap]hose holding out for the chance of full health care repeal in 2013 should realize how difficult that will be after health care alliances worth billions are already formed, warns Scott Gottlieb, a practicing doctor and government policy adviser.
Hospitals are investing billions of dollars into new mergers, joint ventures, and alliances in the health care industry right now, said Gottlieb at an American Enterprise Institute event on Monday.
The industry is already posturing for, and anticipating, government support of a widespread integrated health care model, called Affordable Care Organizations (ACOs). ACOs are mandated under the Health Care Affordability Act. Testing of best practices is underway.
Doctors have been selling their private practices en masse to meet the new demand, according to the American Medical Association.
By next year, 60 percent of doctors will be working for hospitals, nearly double the number five years ago. They are aligning with hospitals so that they will be better positioned to take advantage of the changes.
Having already made considerable investments, they will fight repeal of the Health Care Act with a Republican majority in 2013 if it comes to that, says Gottlieb.
If nothing is done to stop the swift development of ACOs, they will effectively become health care monopolies, resulting in less choice for health care consumers, says Gottlieb. Hospitals are poor innovators, so we can expect that quality will also suffer, he predicts.
At least one private practice doctor, Howard Smith, 65, is extremely concerned about the effect of cost sharing under collectives. Smith is afraid that ACOs will lead to “deadly medicine,” since price caps will impose limits of the quality of care, leading to increased risks.
“What this health bill has created is a situation where my highest duty is to the institution, to the collective,” he said.
The American Medical Association supported its members getting involved in government-funded demonstration programs to test the new legislation and get a head start on the new arrangements.
Just last week, the Centers for Medicare and Medicaid Services (CMS), announced the establishment of the Center for Medicare and Medicaid Innovation within the Department of Health and Human Services. It is currently accepting input from stakeholders.
The new center will direct demonstrations of ACOs and establish best practices for providing care and paying providers under the new system. Testing will involve 1,200 people throughout eight states receiving care in their homes, over 195,000 people on Medicare, and financial awards of up to $1 million for programs in 15 states.
Right now, CMS, along with other responsible departments, including the Federal Trade Commission, have begun work on drafting the regulations that will guide payment sharing for ACOs. Even the government seems to be aware of the potential pitfalls of the ACO model.
“The promise of ACOs, that creative health care practitioners can collaborate legally to deliver higher quality health care at lower cost, offers a real opportunity for health care reform,” said Jon Leibowitz, chairman of Federal Trade Commission, to stakeholders in a published transcript of a roundtable discussion held in early October.
“If ACOs end up stifling rather than unleashing competition, we will really have let one of the great opportunities for health care reform slip away,” he added.
Once the ACOs are set up, they will most certainly become providers of health care for the health care exchanges, which are coming in 2014, says Gottlieb.
Talking to CEOs of health care plans, he says, “None of them think that this can go away.”
Hospitals are investing billions of dollars into new mergers, joint ventures, and alliances in the health care industry right now, said Gottlieb at an American Enterprise Institute event on Monday.
The industry is already posturing for, and anticipating, government support of a widespread integrated health care model, called Affordable Care Organizations (ACOs). ACOs are mandated under the Health Care Affordability Act. Testing of best practices is underway.
Doctors have been selling their private practices en masse to meet the new demand, according to the American Medical Association.
By next year, 60 percent of doctors will be working for hospitals, nearly double the number five years ago. They are aligning with hospitals so that they will be better positioned to take advantage of the changes.
Having already made considerable investments, they will fight repeal of the Health Care Act with a Republican majority in 2013 if it comes to that, says Gottlieb.
If nothing is done to stop the swift development of ACOs, they will effectively become health care monopolies, resulting in less choice for health care consumers, says Gottlieb. Hospitals are poor innovators, so we can expect that quality will also suffer, he predicts.
At least one private practice doctor, Howard Smith, 65, is extremely concerned about the effect of cost sharing under collectives. Smith is afraid that ACOs will lead to “deadly medicine,” since price caps will impose limits of the quality of care, leading to increased risks.
“What this health bill has created is a situation where my highest duty is to the institution, to the collective,” he said.
The American Medical Association supported its members getting involved in government-funded demonstration programs to test the new legislation and get a head start on the new arrangements.
Just last week, the Centers for Medicare and Medicaid Services (CMS), announced the establishment of the Center for Medicare and Medicaid Innovation within the Department of Health and Human Services. It is currently accepting input from stakeholders.
The new center will direct demonstrations of ACOs and establish best practices for providing care and paying providers under the new system. Testing will involve 1,200 people throughout eight states receiving care in their homes, over 195,000 people on Medicare, and financial awards of up to $1 million for programs in 15 states.
Right now, CMS, along with other responsible departments, including the Federal Trade Commission, have begun work on drafting the regulations that will guide payment sharing for ACOs. Even the government seems to be aware of the potential pitfalls of the ACO model.
“The promise of ACOs, that creative health care practitioners can collaborate legally to deliver higher quality health care at lower cost, offers a real opportunity for health care reform,” said Jon Leibowitz, chairman of Federal Trade Commission, to stakeholders in a published transcript of a roundtable discussion held in early October.
“If ACOs end up stifling rather than unleashing competition, we will really have let one of the great opportunities for health care reform slip away,” he added.
Once the ACOs are set up, they will most certainly become providers of health care for the health care exchanges, which are coming in 2014, says Gottlieb.
Talking to CEOs of health care plans, he says, “None of them think that this can go away.”
