How A Flaw In The ACO Model Leaves Patients Out

Michael F. Arrigo | Government Health IT | September 24, 2012

While federal legislation focuses on payor / provider synergies, there is nothing in the mandated programs beyond pilot projects or experiments according to the legislative texts.

According to ATUL GAWANDE writing for the New Yorker, ”Turn to page 621 of the Senate version, section entitled “Transforming the Health Care Delivery System.” Does the bill end medicine’s piecemeal payment system? Does it replace paying for quantity with paying for quality? Does it institute structural changes that curb costs and raise quality? It does not. Instead, what it offers is . . . pilot programs.”

The Patient Protection and Affordable Care Act fails to consider what will keep patients coming back to a network of payor – provider efficiencies in an Accountable Care Organization. In other words – if a patient doesn’t know that they will pay less out of pocket expense or realize improved health via the ACO, why would they stay in the network?  PPACA ignores some  Tenets of Classical Economics including...