How ObamaCare Micromanages Medicine
When the Obama administration announced the release of new regulations designed to encourage medical providers to work together through accountable care organizations (ACOs), Health and Human Services Secretary Kathleen Sebelius declared that the new rules would "improve the quality of care patients receive and help lower costs." Dr. Mark McClellan, a Brookings Institute scholar and major backer of the rules promised that ACOs would "enable care providers to get paid more when they do what they really want to do for patients--provide better care at a lower cost." When ObamaCare's backers talk up the law's "delivery system reforms," the ACO rules are the sort of thing they're talking about.
The folks at The Cleveland Clinic, a highly integrated provider organization that has been touted as a model for the sort of team-driven health care that ACOs are supposed to encourage, aren't buying the promises made by the administration and its backers. Last month, I noted that the Clinic was disappointed with the regulations. Since then, its officials have expanded their criticism in a new letter written to Medicare director and superstar ACO-wonk Donald Berwick.
According to the letter, posted by Modern Healthcare, the Clinic staff is "disappointed generally with its content."
Rather than providing a broad framework that focuses on results as the key criteria of success, the Proposed Rule is replete with (1) prescriptive requirements that have little to do with outcomes and (2) many detailed governance and reporting requirements that create significant administrative burdens.
These aren't guidelines made to encourage better care. They're rules and requirements designed to micromanage the practice of medicine at the federal level.
