Saturday, August 29, 2020

Another ACO horror story - Kip Sullivan

Vermont is learning that ACOs are no different from HMOs. They don't function as advertised, they encourage consolidation, and you never know what they did with the money they get. Vermont's state auditor released a report on June 26 on a giant Vermont ACO with the ominous name One Care (as in "one ring to rule them all"). One Care was created by the two largest hospital-clinic chains that serve Vermont in 2016. The auditor has two complaints. He says the state has no idea whether OneCare is cutting costs, and it has no idea whether it's improving quality. That's exactly what happened here in MN after our legislature privatized Medicaid and MinnesotaCare in the 1990s. Unfortunately, our legislature and state auditor haven't lifted a finger to address that problem. It's also exactly what's happening with MN's Medicaid ACO program, known as "Integrated Health Partnerships." A former VT commissioner, Patrick Flood, just published this blistering critique of the Green Mountain Board, the agency that is supposed to oversee One Care. Flood praises the auditor's report, and suggests the Green Mountain Board is making the auditor's job even harder by not disclosing data. He quotes the CEO of One Care saying she has no idea why the ACO lost money last year. The great irony of the "accountable care organization" fad is it makes accountability much harder to achieve. Kip

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