Monterey : Hospitals Being Pressured To Increase Quality Of Care, Reduce Costs : View From A Private

Duty Caregiver Serving, Carmel, Carmel-by-the-Sea, Marina, Monterey, Pacific Grove, Pebble Beach,
Salinas & Seaside, California

Hospitals and Doctors are unhappy about a new Obama administration initiative that encourages them to
create new organizations to coordinate the care of groups of Medicare patients. The administration is
trying to create "accountable-care organizations" or ACOs, which would be more efficient than hospitals
and other health care providers. Savings resulting from these programs would be shared by the ACOs
and the Federal government. Those in the medical field say they are unlikely to participate in the
voluntary program unless it's overhauled because the proposed rules are too onerous and the financial
incentives to participate too weak. There are detailed requirements such as 65 quality measures which
many in the in the medical field say would be too expensive to implement. "It's pretty much a nonstarter
as structured," Anders Gilberg, an official at the Medical Group Management Association, told The Wall
Street Journal June 3. The American Medical Group Association released a survey showing that 93% of
its members would not enroll as ACOs as the proposal sits now. Responses to the proposal are due by
June 6, and the program will likely see an overhaul. Jonathan Blum, deputy administrator of the Centers
for Medicare and Medicaid Services said the agency has been "actively seeking input at every stage of
the rule-making process, and we're confident that the final rule will reflect the valuable input we've
received." Although most Doctors and Hospitals approve of the program in theory, the risk-reward profile
of the program just doesn't seem attractive enough. Some hospitals are already involved in similar
programs, although not voluntarily. I wrote recently on my blog about a plan by WellPoint, a large
insurance company, cutting off annual payment increases to about 1,500 hospitals across the country if
they don't live up to the health insurer's definition of quality patient care. WellPoint has initiated a 51 point
list of indicators of treatment quality, including what the facility does to try and prevent a relapse after the
patient leaves the hospital, whether it follows a safety checklist and how satisfied the hospital's patients
say they are with their treatment. Facilities with poor scores won't receive any payment increase. Many
insurance companies, and the government, are trying to work with health industry officials to reduce costs
and at the same time increase the quality of care. It won't be an easy task.

http://online.wsj.com/article/SB10001424052702303654804576349794068956906.html

http://www.familyinhomecaregiving.com/blog/index.html?page=4

About Richard Kuehn & Family inHome Caregiving of Monterey:

After more than a decade of caregiving, both in a professional environment and for a 97 year old family
member I was dissatisfied with service from local caregiving agencies. I became convinced of the need
for a service which provides very personal assistance to the elderly and founded Family inHome
Caregiving serving the Monterey Peninsula. Please visit my blog where I talk about important senior
issues at:
http://www.familyinhomecaregiving.com/Blog