Fwd: qotd: New CMS quality data on ACOs

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-------- Original Message --------
Subject: qotd: New CMS quality data on ACOs
Date: Tue, 25 Feb 2014 10:19:22 -0800
From: Don McCanne <don@mccanne.org>
To: Quote-of-the-Day <quote-of-the-day@mccanne.org>



Kaiser Health News
February 21, 2014
Medicare Data Show Wide Differences In ACOs' Patient Care
By Jordan Rau

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.

http://www.kaiserhealthnews.org/Stories/2014/February/21/Medicare-Data-Shows-Wide-Differences-In-ACOs-Patient-Care.aspx

****


Comment by Don McCanne, M.D.

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!