I operate a medical practice (independent physical therapy clinics specializing in musculoskeletal pain problems), so I stay very up to date re emrging health care regulations. Widely reported throughout various states local newpapers is confirmation that Medicare (and several private insurance companies) has launched a program called ACO (accountable care organizations) whereby all docs will be employed by their local hospitals, hospitals organized into larger corporate medical provider corporations, and all health care will be provided by that organization (private practices mostly excluded). The hospital corps will be paid a flat rate per person per year to provide all health care. Docs will be "encouraged" to keep health services minimized to reduce utilization of costly care (MRI and other costly imaging, minimize referral to costly specialists especially if they may be surgeons, minimize referrals to phsical therapy, anything that uses hospital resources). The goal is to reduce use of health care resources that provide care, so that hospital organization gets paid but does not expend those dollars on so much care, allowing them to keep the resulting surplus.
The goal is laudable, ie, reduce health care costs. And it should reduce needless tests and procedures. But how far will they go to minimize costs so they can keep the surplus as profits? Docs will get bonuses or penalties based on how they do at rationing care. This is very similar to the HMO concept of the 1980-90s except the proftis stay with the hospital rather than the inusrance co. How far will they go?? What care will YOU be denied?? Sarah Palin death panels inching toward reality?
Private insurers are on a similar path. Many insurers require patients needing PT to undergo review before care, will be allowed a few treatment sessions (very few, as we have seen). Then patient pays $40 copay while the insurer pays $10, and we providers must eat the loss. I get $50 for a treatment session at costs me $75. For my clinic business income is down 70%. I will be out of operating funds by sept and will likely close my practice. But that is just me. What about those who need the care? By ghe way, those rationing programs say the patient approved for 3-4 sessions for their back pain can then have NO therapy for that body part ever again in their lifetime.
obamacare is here and blossoming rapidly. Next year brings lots of more new regulations to reduce ca and its costs. But at what price. You sustain another back pain episode and you cannot have any PT, and cannot pay for it out of your pocket per the rules.
That is today's update from the front line of YOUR health care. The Soviets called it 'central planning'.
I highly doubt Repubs will roll this back in light of the huge tax income that is part of the 2013 part of Obamacare, plusthenzeal to reduce health costs.
Google ACO health care for more details
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Originally Posted by BREWER
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