Remarks as prepared for delivery by Secretary Sebelius on June 27th, 2011, Washington, DC.
“Improving care is clearly the best approach to addressing rising costs – especially compared to recent proposals that would simply cut Medicare and Medicaid, without doing anything to address underlying growth in health care spending. But it’s also clear that we are not improving fast enough. So our challenge is to speed it up.”
The Medicare patients will be invisible to the providers for one year so as to discourage lowering costs improperly. How will this affect the providers’ ability to design cost-lowering programs?
ACOs are not closed networks;
When ACO beneficiaries go outside the ACO, and healthcare cost savings or excess is passed onto the ACO, even though the ACO had no control over such things. Imagine how seasonal residence plays into this;
Demonstration projects show a lot of patient “churn,” further challenging the ability of an ACO to control costs;
It looks like the two sided model will put 25% of reimbursement at risk;
Even Mayo, Geisinger and Cleveland are saying they won’t participate in ACOs.
The Federal HITECH Act will provide over $20 billion to promote health care provider use of electronic health records. Starting this year, “meaningful” EHR users can earn $44,000 under Medicare and $64,000 under Medicaid over 5 years. Those who enroll early will benefit the most, because nearly 70% of the payments come in the program’s first 2 years. Physicians who have engaged in PQRI and electronic prescribing in the past few years have put another $6,000 to $8,000 in their pockets.
The Federal push for electronic health records isn’t going away. Over $7 billion has been released to fund state capacity for exchanging health information across the health care system both within and across states. The Florida Agency for Health Care Administration received nearly $21 million to develop this state’s health information infrastructure. The intent is to assure a fully connected national health care IT system to provide all health care providers and their patients seamless access to a patient’s medical information.