As the article states:
“But probably the driving reason was the changing landscape of health
care delivery and the uncertainty around that,” Dr. Johnson said. “The
thought was that we were going to be in a safer position if we were
aligned and affiliated with a network.”
But as St. Luke’s moved forward with its plans to acquire most of the
Saltzer Medical Group — a practice of about 50 physicians in Nampa,
Idaho, about 20 miles west of Boise — St. Alphonsus filed an injunction
to block the purchase.
St. Alphonsus argues that St. Luke’s dominance is hurting its business
because it has experienced steep declines in hospital admissions and
referrals from physicians acquired by St. Luke’s.
St. Luke’s argues that it is positioning itself to compete better by
improving its ability to coordinate patient care. In September, it filed
an application with Medicare officials to become a so-called
accountable care organization. Hospitals designated as A.C.O.’s
can typically keep a portion of any savings they generate. The
hospitals reduce health care costs by avoiding unnecessary tests and
procedures or by keeping patients out of the hospital, while still
meeting quality targets.
First, who do you think is paying for the law suits, we are. Second, what is happening to care as these law suits fly back and forth. We are getting poorer care. The ACOs, will merger, then merge, then merge again, into massive regional conglomerates. Independent physicians will disappear becoming employees of the mega institutions.
One should remember that we have almost 20% of the economy in this one sector, and that one must look at what catalysts will cause massive consolidation. The ACOs may beat out anything that the HMOs tried to do. The are becoming natural monopolies, they get to hide everything, and the natural tension that in the HMO days between patients, physicians, and hospitals, that is now gone. In fact the ACO will also become the insurer.
One could have envisioned a massive plan for the ACA to create the ACO as insurer, provider, etc. They will be able to get so big that even the Government will be limited. Just my nightmare of the day.
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