Monday, February 13, 2017

THE ACA - Offer Savings?

"Does this Obamacare experiment offer significant savings?" PBS NewsHour 2/6/2017


SUMMARY:  One of the goals of the Affordable Care Act was to develop organizations that offer doctors and hospitals a deal: In exchange for more efficient care for Medicare recipients, providers receive a share of the savings as a bonus.  Now that ACOs have become embedded in the health care system, are they really working?  Special correspondent Jackie Judd reports.

JOHN YANG (NewsHour):  In that interview with FOX News that aired yesterday, President Trump said it could take longer to repeal and replace Obamacare than he'd indicated previously.

Last month, the president said he'd offer a replacement plan as soon as his health and human services secretary is confirmed.  But Mr. Trump told Bill O'Reilly that it could take until next year.

BILL O'REILLY, Host, “The O'Reilly Factor”:  Can Americans in 2017 expect a new health care plan rolled out by the Trump administration, this year?

PRESIDENT DONALD TRUMP:  In the process, and maybe it will take until some time into next year, but we are certainly going to be in the process.  Very complicated.  Obamacare is a disaster.

You have to remember, Obamacare doesn't work, so we are putting in a wonderful plan.  It's statutorily takes a while to get.  We're going to be putting it in fairly soon.  I think that, yes, I would like to say by the end of the year, at least the rudiments, but we should have something within the year and the following year.

JOHN YANG:  Most of the focus on the Affordable Care Act has been on coverage.

But among the goals of the 2,000-page law is to develop something called Accountable Care Organizations.  They offer doctors and hospitals a deal.  In exchange for better and more efficient care for Medicare recipients, the providers get a share of the savings.

Special correspondent Jackie Judd reports.

JACKIE JUDD, special correspondent:  Creating health care for the future sometimes means going back to the past.

Nurse practitioner Dana Sheer makes old-fashioned house calls to high-risk patients, like Howard VanVleck, who suffers from a neurological disorder.  On this day, a cough alarmed his wife.

LISA VANVLECK, Wife of Howard:  When I called the doctor's office about it, they said, can you bring him in?  And I said, really not.

JACKIE JUDD:  This visit was low-tech and quick, but, if needed, VanVleck can get an in-home ultrasound, an EKG, even a chest X-ray.

DANA SHEER, Nurse Practitioner:  Our program is really aimed at trying to figure out ways that we can provide really good, cost-effective, quality care at a patient's home, at a place where they can actually thrive and do better.

JACKIE JUDD:  How many times during that year would he have been in the hospital if you or a colleague hadn't visited?

DANA SHEER:  Likely every time.

JACKIE JUDD:  Sheer is part of the Accountable Care Organization, or ACO, run by Partners HealthCare, which collaborates with several Massachusetts hospitals.

At Mass General, Jason Wasfy does the once unthinkable for a cardiologist.  He routinely e-mails or video-chats with patients.

DR. JASON WASFY, Massachusetts General Hospital:  There are cases, high cholesterol, for example, where I don't Actually need to actually physically examine the patient.

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