Fixing Flaws in Healthcare

On March 31, 2011 the Centers for Medicaid and Medicare Services (CMS) released the proposed guidelines for an Accountable Care Organization (ACO), a subprogram of the Medicare Shared Savings Program, Section 3022 of the Affordable Care Act.  The CMS currently processes the comments to this proposal, and will release the results soon.

No matter what forms will assume, they are yet another attempt by the government to fix the quality and accessibility of healthcare.  In the 90s this mission lead to the formation of Health Maintenance Organizations (HMOs), which notoriously failed to live up to their high expectations.  As ACOs don’t officially exist yet, the only potential lies in the ideas behind their creation and implementation.  Lawmakers decided to create ACOs in order to create a care monitoring system that holds providers (rather than the payer) accountable for the quality of care a patient receives; furthermore, those who successfully participate in ACOs and provide quality care are eligible to receive incentive monies.

All of these regulations seem pretty standard in the arsenal of healthcare-fixing implements.  And maybe that’s the problem.  Maybe instead of looking at the problems in healthcare as problems in providing health we need to look at them as problems in the machinery behind the service.  In other words, the business of caring for health is flawed.  We don’t treat epilepsy by splinting limbs even though it’s the body that shakes, nor should we treat the problems with care provision as ones of the doctor when it is primarily the institution behind her/him creating problems.

To that end, we are supportive of efforts by the Center for Improving Value in Healthcare (CIVHC) and their efforts to lead Payment Reform while at the same time remaining cognizant (and active) of the quality Delivery of care, and recognizing the need for increased Consumer Education for an true reform to take root.

Let us know what you think about operating healthcare like a business by responding to this post!  And look for an upcoming article from Clinic Service about ACOs and how they’re going to rock the boat for better or worse.

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About Clinic Service: Founded in 1974 by James Grow as a medical billing company, Clinic Service has never strayed from its mission: To Maximize the Profit for Physicians and Medical Practices. We believe our market leadership and growth in medical billing and supporting services like EMR and EHR is a result of our focus on customer experience and our internal culture. The Clinic Service culture is founded on learning and personal growth.

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