Health Law Uncertainty Sets Up ‘Moment-Of-Truth’ Situations
This circumstance is particularly acute regarding states' decisions about setting up health exchanges.
Politico: Health Reform Law Poses Quandary For States
If the Supreme Court upholds the health reform law this summer, states could be forced to a moment-of-truth situation: Do they set up a health insurance exchange, or do they let the feds come in and run theirs? (Millman, 4/22).
Meanwhile, Modern Healthcare provides a pair of stories that explore the dynamics involved in the industry's interest in accountable care organizations.
Modern Healthcare: Then There Were Six—ACOs
Ten physician groups agreed in 2011 to extend their test of Medicare accountable care, which began in 2005, for another two years. Now, six remain. Three did not go far. Dartmouth Hitchcock in New Hampshire, Park Nicollet Health Services in Minnesota and the University of Michigan all moved into another more sophisticated Medicare accountable care experiment known as the Pioneer program in January. But one made a complete exit: the Everett (Wash.) Clinic. After six years working with Medicare to make accountable care work, the group practice preferred Medicare managed care, or Medicare Advantage (Evans, 4/20).
Modern Healthcare: No ROI In ACO
The healthcare reform law created a flurry of activity among hospitals and systems laying the groundwork to get in on Medicare's new incentive programs for accountable care organizations. But most of the largest for-profit healthcare groups have been absent from the clamor, hardly represented in the first few waves of participants in the CMS experiments. Instead, their executives have said publicly and privately that they're waiting to see how the program evolves before investing resources in it (Kutscher, 4/21).