Hospitals discover that having a cheaper place to send those sore throats and fevers and ankle sprains that would otherwise end up in the ER makes economic sense. They also want them because they fit in with new risk-sharing arrangements, notably accountable care organizations. Insurers and investors like what they’re seeing, as well.
Detailed information about the accountable care organization (ACO) contracts that organizations have negotiated with commercial payers is hard to come by. The word accountable is very much in vogue and being used to describe any payment system that’s not strictly fee for service.
The ACA encourages inmates to sign up for Medicaid because good, consistent care cuts down on recidivism. This is all new, though, and Medicaid managed care plans will need to coordinate their efforts with state officials to help this problematic population. Still, it’s an example where the right thing to do aligns with financial benefits.
The president of the American College of Physicians notes that physicians are feeling the strain these days, what with new regulations, EMRs, maintenance of certification, and more cost being shifted toward providers. Be patient, he tells doctors. Things will get better.
Complementary and alternative medicine (CAM) seems pretty entrenched, although health plan formularies don’t usually include CAM therapies. Perhaps it is time for P&T committees to monitor outcomes from homeopathic drug studies and at least report their experience in the literature.