Policymaker: Well, we’re pretty excited about these ACO regs

Reporter: These ACOs are really supposed to lower healthcare costs and improve quality?

Policymaker: You bet. We really believe in them. It’s the a common sense model that is primary care driven.

Reporter: So, then I suppose all the Medicare patients are gonna be in them, so that we get the cost reduction and health benefits?

Policymaker: Ummm, no. We don’t want to require that. We want to design the perfect system, but we don’t want to require anyone to use it.

Reporter: Why not? If you believe in it, why not just implement it?

Policymaker: It’s not American to require people to do anything.

Reporter: That’s confusing. What’s the value of having spent so much time and money on the perfect system if it isn’t actually implemented?

Policymaker: Oh, it will be! Trust me, when Medicare patients see the value of being in a healthcare delivery model that makes more money by reducing the amount spent on care, they’re gonna flock to it.

Reporter: How will you know?

Policymaker: Great question. We’re gonna track it. We’re gonna assign the patients to an ACO and then watch the cost fall and the quality rise.

Reporter: How is the patient gonna feel about being assigned to an ACO, one where maybe their physician isn’t even participating?

Policymaker: Oh, no problem at all. Good care is good care. We think the physician patient relationship is overrated.

Reporter: Really? It seems so personal and essential.

Policymaker: Not really. We just think that. We’re not even gonna tell physicians who’s in an ACO or not?

Reporter: Why not?

Policymaker: Cause we think physicians might prefer the money from reducing costs over helping people get well.

Reporter: So you think paying physicians for saving money will cause them to provide insufficient care?

Policymaker: No, we think paying them to provide really excellent care will drive costs sky high.

Reporter: So is the goal to reduce the quality of care?

Policymaker: No, just the amount of it, because the more you provide, the more it costs.

Reporter: Sounds like healthcare reform is about rationing.

Policymaker: (Laughs). Oh my, no! That would never fly. What we have to do is to make sure patients get exactly what they want and, at the same time, reduce costs.

Reporter: And ACOs will do that?

Policymaker: You bet. That’s the magic. By providing the perfect system and then by mixing it with patient choice and secrecy, we’re convinced we’ll see reduced costs and higher quality.

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