Accountable Care Organization questionnaire

[aja8888]

MY DW just got this lengthy document asking a lot of personal health questions about her heath status, etc. From what I can glean from the internet, this looks like it could be long term trouble for us seniors that wish to maintain our choices of doctor's etc under Medicare and our supplemental insurance (for those that have it).

While I know it's not fair to assume the Gov has underlying motives for collecting scads of personal health care data and somehow making it difficult for seniors to maintain their freedom , I just have a feeling this is not a good thing, especially since it is not clear why this would be good for us. (maybe they think we are all stupid and need to be told what to do when?)

I see their is an option to opt out with a call to Medicare and choosing the right boxes to fill out, but before we do that, are there members here who have gone through this ACO business in detail and can lend some advice?

Thanks.

 

[MichaelB]

KFF just published a FAQ on ACOs FAQ On ACOs: Accountable Care Organizations, Explained - Kaiser Health News

One of the main ways the Affordable Care Act seeks to reduce health care costs is by encouraging doctors, hospitals and other health care providers to form networks which coordinate patient care and become eligible for bonuses when they deliver that care more efficiently.

The law takes a carrot-and-stick approach by encouraging the formation of Accountable Care Organizations (ACOs) in the Medicare program. Providers make more if they keep their patients healthy. About four million Medicare beneficiaries are now in an ACO, and, combined with the private sector, more than 428 provider groups have already signed up. An estimated 14 percent of the U.S. population is now being served by an ACO. You may even be in one and not know it.

While ACOs are touted as a way to help fix an inefficient payment system that rewards more, not better, care, some economists warn they could lead to greater consolidation in the health care industry, which could allow some providers to charge more if they’re the only game in town.

 

[aja8888]

KFF just published a FAQ on ACOs FAQ On ACOs: Accountable Care Organizations, Explained - Kaiser Health News

Thanks Michael.

After reading the piece written by Kaiser, we are leaning toward opting out. It's looking like an HMO run by the government, and what scares us is the possibility of having a third party pick and choose our (DW's now) medical providers (and choice of medications?). Even though the article says (paraphrased) "if you don't like our pick of doctor, you can pick one of your choice outside of the ACO"...But how long would that be an option?

I wonder why I have not received the ACO forms yet? I suppose I could just call Medicare and ask....

 

[MichaelB]

Scepticism is understandable, although this becomes a bit of a catch-22, as we all want to see greater control over health care costs in the US but don't care for the specific measures.

An ACO inviting you to participate should articulate clearly how you will benefit from their initiative, and if they can't do that there is no reason to give them the benefit of the doubt.

 

[aja8888]

An ACO inviting you to participate should articulate clearly how you will benefit from their initiative, and if they can't do that there is no reason to give them the benefit of the doubt.

Exactly.

 

[FIRE'd@51]

Even though the article says (paraphrased) "if you don't like our pick of doctor, you can pick one of your choice outside of the ACO"...But how long would that be an option?

Possibly about as long as "If you like your insurance, you can keep your insurance" or "If you like your doctor, you can keep your doctor". Oh, and BTW, Kaiser isn't exactly an impartial observer here.

 

[rodi]

Oh, and BTW, Kaiser isn't exactly an impartial observer here.

You understand that Kaiser Family Foundation (quoted above) is not related to Kaiser Permanente (the large HMO provider.) It hasn't had any ties at all since 1985. Kaiser Permanente was started by Henry Kaiser to provide benefits for his steel workers. Kaiser Family Foundation was a separate charity/non profit he started/endowed to fund research. It later changed it's focus to more analysis/education on health care issues.

Kaiser Family Foundation - Wikipedia, the free encyclopedia
Henry J. Kaiser - Wikipedia, the free encyclopedia