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Healthcare IT In The Obamacare Era
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David F. Carr
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David F. Carr,
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2/20/2014 | 12:27:42 PM
BusinessWeek on ACOs: Paying Doctors to Shun Hospitals
Paying Doctors to Shun Hospitals http://buswk.co/LYItVE

Points out many ACOs are being built independent of hospitals (which ought to be a concern for hospital leaders)
David F. Carr
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David F. Carr,
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2/19/2014 | 10:18:51 AM
Re: From "death panels" to an improved system of care
Not my intent to give credence to the "death panels" thing. I do have some respect for the law of unintended consequences, however. When lawmakers (or insurance companies, for that matter) say they are realigning incentives to reduce overutilization and emphasize quality over quantity of care delivered, that's a fine goal. Whether it results in denial of needed care bears watching. Then again, the bad, old system we're trying to move away from had a bad habit of denying legitimate claims and denying insurnace because of preexisting conditions.

Most of the people I spoke with are optimistic that this system represents a real improvement.
David F. Carr
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David F. Carr,
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2/18/2014 | 4:13:12 PM
Re: From "death panels" to an improved system of care
Most of the people I interviewed saw the accountable care trend as inevitable, appropriate, and necessary.

I'm just contrary enough to start worrying when so many people agree on something.
RobPreston
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RobPreston,
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2/18/2014 | 3:23:57 PM
Re: From "death panels" to an improved system of care
As with a lot of ambitious policy initiatives, accountable care makes sense in theory, but can it be implemented without a rash of unintended consequences? There will certainly be negative ramifications, but will the greater good be served? (I don't know.)
David F. Carr
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David F. Carr,
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2/18/2014 | 1:50:21 PM
From "death panels" to an improved system of care
I don't deal much here with the politics around Obamacare, but I did address it in this column a couple of weeks ago, Obamacare: Separating Politics From Practicalities.

I suppose it must have been the language in the ACA about attacking overutilization of the system that gave rise to the "death panels" meme of a few years ago. I admit it makes me twitchy to hear all this talk about reducing hospital readmissions (what if someone really needs to go back to the hospital, are the incentives going to change in a way that discourages care when we need it?). The goal, of course is to achieve a greater focus on follow up and preventative care, which are less expensive in the long run than hospital and emergency room care.

Do you believe in the potential of accountable care?
Laurianne
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Laurianne,
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2/18/2014 | 1:50:11 PM
EMR standard
"While it would be helpful to have one EMR standard, for now Rab is trying to steer participants toward four or five preferred vendors." It is refreshing to hear someone be pragmatic about this. Setting one standard would not be practical.


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