“Pioneer” Program Not Working
Almost a third of 32 hospitals and health systems involved in an experiment aimed at changing the way medical providers are paid may exit the program, a potential threat to the Affordable Care Act’s ambitious cost-saving goals.
Medicare’s “Pioneer” program is designed to save money by more efficiently managing care for patients with chronic diseases, such as diabetes and dementia. The providers agreed to a three-year plan to forgo traditional fee-for-service payments, where hospitals charge for every procedure, and instead get a fixed monthly stipend for individual patients…
Presbyterian Chief Executive Officer Jim Hinton, who is also the chairman-elect of the American Hospital Association, warned of potential problems in the Pioneer program in an April 30 interview.
Participating hospitals are responsible for controlling costs for a population of Medicare patients assigned to them, but their ability to manage the patients’ care is limited, Hinton said. For example, they can’t forbid the patients from seeing doctors or other health providers who aren’t part of the Pioneer system.
Also, Medicare has lagged, by about six months, in providing the Pioneer systems medical claims data they need to track spending on their assigned patients, according to Hinton. (Bloomberg)
The incentives are convoluted…
The Administration assumed the best-known hospitals would want to be part of this project. But, many of those didn’t really see why they should change their practice style to accommodate someone else’s ideas.
That sort of like picking the best chefs in America and asking them to make recipes created by a bureaucratic committee. The results would probably not be any better that if an amateur made the same recipe.
Great point. I think that this whole system is based on optimistic expectations.
What if the bureaucratic committee made the recipes directly out of the best chef’s suggestions? But I get your main point.
“Also, Medicare has lagged, by about six months, in providing the Pioneer systems medical claims data…”
Who didn’t see this coming? Right now it’s only 32 voluntary hospitals, what happens when the entire medical system is subject to this incompetence?
It may work in clusters, but in the aggregate, it’s looks like it’s designed to fail.
If results are not evident after the prescribed time, its gotta go!
I have a feeling that the results won’t be heeded.
A lot of the cost-saving goals the law has will face challenges.
It’s the same capitation that was hurled on its ass in the 80’s from HMOs. It didn’t work then but Obamacare thinks they can create a new lexicon and dress it up to divert consumer awareness.
And this from above: “Also, Medicare has lagged, by about six months, in providing the Pioneer systems medical claims data they need to track spending on their assigned patients, according to Hinton.”
And this was supposed to be a demonstration experiment? Who decided to go forth with this experiment without the most necessary tools?
Just another example of bureaucratic failure which is getting ready to explode on our entire healthcare system.
“Just another example of bureaucratic failure which is getting ready to explode on our entire healthcare system.”
Exactly. We think government is bad now, just wait until they take complete control over life and death.