360 Busy Bureaucrats

April 20, 2016

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The delivery of medical care is being altered without your consent. I call this Obamacare II. This is the part of Obamacare most people don’t know about. Unlike the well-known insurance reforms of Obamacare I (as I call it), Obamacare II is focused on transferring power from physicians and patients to government officials and managed care executives.
Obamacare II uses electronic health records, payment controls, consolidation of insurers, doctors and hospitals, accountable care organizations (ACOs), profiling, surveillance, wellness programs, “health disparities” initiatives, ACA regulations (e.g. proposed gender “nondiscrimination” rule), the not-yet-set-up Independent Payment Advisory Board (IPAB) and CMS’s Center for Medicare & Medicaid Innovation (“Innovation Center”) to take control of treatment decisions.
Consider the “Innovation Center.” The Associated Press reports this week:
“In a sprawling, nondescript office park near Baltimore, some 360 people at the Center for Medicare & Medicaid Innovation are trying to change the health care system, using the government’s premier insurance program as leverage.”
Did you catch that? The Innovation Center is working to change the entire health care system using Medicare. Most physicians and hospitals participate in Medicare, opening them up to its 132,000 pages of regulations and the Medicare changes in Obamacare’s 20,000+ pages of regulations – and jail time and financial penalties for failure to comply.
The Center has initiated 70 experiments so far. Most patients are clueless. As AP notes, “Right now very few of Medicare’s 55 million beneficiaries have any idea that changes they’re starting to see are part of a deliberate effort to remake the traditional side of the program.” The word “traditional” means those not in Medicare Advantage managed care plans, where HMO executives can already control care by payment decisions and treatment protocols.
Congress took itself out of the driver’s seat, reports AP:
“Successful experiments an be adopted as permanent policy without seeking approval from Congress.”
But Congress has mandated Alternative Payment Models (APMs) -- under Obamacare and the 2015 GOP “Doc Fix” bill (MACRA). Instead of being paid for their time or their services, physicians will be paid for “value” as defined by outsiders. The CMS Innovation Center has initiated most of the APMs listed below, including ACOs and bundled payments (click to enlarge):
Thankfully, the Innovation Center’s “future under a Republican president is questionable,” per the Associated Press. Let’s guarantee its demise. Isn’t it time we put citizens instead of bureaucrats in charge of patient health care dollars, data and decisions?
Working with you to free patients and doctors,
Twila Brase, RN, PHN
President and Co-founder
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