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Long Before Reaching … Dentistry

[By Darrell K. Pruitt DDS]

HCPlexus recently partnered with Thompson Reuters to conduct a nationwide survey of almost 3,000 physicians about their opinions of the quality of health care in the near future considering the Patient Protection and Affordable Care Act (PPACA), Electronic Medical Records, and their effects on physicians and their patients. (See “5-page Executive Summary”)

http://www.hcplexus.com/PDFs/Summary—2011-Thomson-Reuters-HCPlexus-National-P

Results:

“Sixty-five percent of respondents believe that the quality of health care in the country will deteriorate in the near term. Many cited political reasons, anger directed at insurance companies, and critiques of the reform act – some articulating the strong feelings they have regarding the negative effects they expect from the PPACA.”

What’s more, one in four physicians think eHRs will cause more harm than help. So what’s the accepted threshold for the Hippocratic Oath to come into play?

Do you also find excitement in healthcare reform’s surprises? Experiencing the sudden, last minute turns healthcare reform has taken lately is like riding shotgun with Mayhem behind the wheel, texting. Here’s other discouraging news from the same HCPlexus-Thompston Reuters survey: “A surprising 45% of all respondents indicated they did not know what an ACO is, exposing a much lower awareness of ACOs versus the broader implications of PPACA. It appears there has been a lack of physician education in this area.”

ACOs Defined 

Since I also had no idea what an ACO is, I searched the term and came across a timely article that was posted on NPR only days ago titled, “Accountable Care Organizations, Explained.”

http://www.npr.org/2011/01/18/132937232/accountable-care-organizations-explained

Author Jenny Gold writes: “ACOs are a new model for delivering health services that offers doctors and hospitals financial incentives to provide good quality care to Medicare beneficiaries while keeping down costs.” Does that remind anyone of insurance HMO promises just before the bad idea collided with surprisingly intelligent consumers in the early 1990s? Kelly Devers, a senior fellow at the nonprofit Urban Institute, is quoted: “Some people say ACOs are HMOs in drag,” There’s a sharp turn nobody warned us about.

HMO Differentiation 

Further blurring the difference between ACOs and HMOs, Gold adds “An ACO is a network of doctors and hospitals that shares responsibility for providing care to patients. Under the new law, ACOs would agree to manage all of the health care needs of a minimum of 5,000 Medicare beneficiaries for at least three years.” I wonder if we’ll see a resurrection of HMO gag orders preventing physicians from discussing effective but expensive treatment alternatives not offered by the ACO.

As expected, not only are hospitals and doctors competing for the opportunity to run ACOs, but so are former HMO insurance agents. Devers explains, “Insurers say they can play an important role in ACOs because they track and collect data on patients, which is critical for coordinating care and reporting on the results.” As a provider, do you trust UnitedHealth’s Ingenix data mining tendencies? A few years ago, NY State Attorney General Andrew Cuomo spanked the company for selling insurers pseudo-scientific excuses to cheat out-of-network physicians.

Just like Health Maintenance Organizations don’t maintain health, insurer-based Accountable Care Organizations will not bring accountability to care any more than the Patient Protection and Affordable Care Act provides patient protection and affordable care. And since I’m exposing blatant bi-partisan deceptions, there is no privacy or accountability in the Health Insurance Portability and Accountability Act, and the “HIPAA Administrative Simplification Statute and Rules Act” doesn’t.

HITECH Funding

Gold suggests that because HITECH rules were written intentionally vague in order to push the envelope of stakeholders’ imaginations, similar to HIPAA’s ineffective security rules I suppose, the doctors’ predictable ignorance of ACOs is understandable.

But then again, all this may not even matter in a few months. According to Howard Anderson, Executive Editor of HealthcareInfoSecurity.com, HITECH funding itself is threatened. He recently posted “GOP Bill Would Gut HITECH Funding – Unobligated HITECH Act Funds Would be Eliminated.”

http://www.govinfosecurity.com/articles.php?art_id=3306

Assessment

While Obama’s healthcare reform teeters between two houses, I encourage consumers to plead with their lawmakers to stop being suckered in by cheap, meaningless buzzwords sprinkled in the titles of bills. I’m hoping we can at least get them to read a little deeper. Be on your toes. Mayhem is “recalculating.”

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

• PRACTICES: www.BusinessofMedicalPractice.com
• HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
• CLINICS: http://www.crcpress.com/product/isbn/9781439879900
• ADVISORS: www.CertifiedMedicalPlanner.org
• FINANCE: Financial Planning for Physicians and Advisors
• INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
• Dictionary of Health Economics and Finance
• Dictionary of Health Information Technology and Security
• Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Practice Management, Pruitt's Platform | Tagged: ACA, ACOs, ADA, Darrell Pruuitt, eDRs, EHRs, EMRs, HIPAA, HIT, HITECH, Jenny Gold, Kelly Devers, Patient Protection and Affordable Care Act | 3 Comments »