Breaking Health Care Research: “Accountable Care” Unlikely
Margot Crouch /
Medicare continues to be a looming problem in the fiscal crisis. In an effort to lower the program’s cost and improve quality of care for the seniors it serves, Obamacare creates accountable care organizations (ACOs), which are supposed to encourage health care providers to band together and create savings through better coordinated care. In a new Heritage research paper, health policy expert John Hoff writes:
The ACO scheme is a microcosm of the PPACA (Patient Protection and Affordable Care Act) and, like it, will not deliver on its rhetorical promises. In the process of failing, it will waste financial and human resources, detract from meaningful reform, and give the Administration one more tool to exert control over Americans’ health care choices.
Hoff explains that the ACO scheme is a complex web of regulations, often internally inconsistent and confused, resulting in an odd structure. As one example, Hoff writes,
Medicare beneficiaries may be surprised to learn that they do not join an ACO as members. Nor is the process voluntary. Strange as it may sound, the CMS ‘assigns’ beneficiaries to an ACO, whether they like it or not…Beneficiaries will not know if they have been assigned to an ACO, or if so, which one. There is no provision for informing beneficiaries that they have been assigned to an ACO.
Writing for Heritage, Dr. Rita Numerof also argues that ACOs are unlikely to actually improve the quality of care or to lower costs, but are likely to benefit the largest health care organizations and enhance their market concentration:
Congress, apparently unmindful of legislating an untested model in a field as complex as health care, included provisions in the PPACA to establish ‘accountable care organizations.’ … It is unlikely that an untested organizational structure will be the most effective way to create ‘accountability for care.’… the likely result will be a concentration of power not in the most efficient and highest quality health care organizations, but in the largest—simply because they control large segments of the market square.
Small reforms to fix the ACO provisions of the new law will not succeed at providing better quality care or driving down medical costs, because the flaws are embedded in the law’s creation of ACOs. Make sure to check out Hoff’s paper in its entirety here.