Why ACOs Won’t Save Money

Shorter Christensen, Flier and Vijayaraghavan: Accountable Care Organizations, groups of healthcare providers providing coordinated care and accountable to patients and mandated under the Affordable Care Act, won’t save money because doctors and patients don’t want to save money.

4 comments… add one
  • jan

    The link above doesn’t work.

    As to the statement about “doctors and patients don’t want to save money”, there has to be some kind of consumer involvement or incentive to save money on anything. If it’s all free, people become passive consumers, rather than ‘thinking’ consumers. Passivity causes a “Oh what the heck, it’s not my money” attitude.

    It’s the same with support for higher taxes. If you have no skin in he game, then sure you see no problems with ‘others’ being taxed more, in order to raise revenue to pay for your stuff. If there was even a minor income tax, spread across the board, you would see greater concern, across the board, more public oversight, across the board, for the money government says it needs for maintenance and expansion purposes.

    Dr. Ben Carson relayed such an idea, of involving everyone in some kind of income tax responsibility, no matter how small that might be, comparing it to tithing when it comes to supporting one’s church. Why is it not the same when it comes to supporting your county’s government?

  • Fixed. Thanks.

    Patients don’t care about higher prices because they’re shielded from them by insurance. That’s true whether the insurance is publicly or privately provided.

    Doctors don’t care about higher prices because a) it means more revenue and b) they self-justify under the heading of “standard of care”.

    Insurance companies don’t care about higher prices because a) they’re frequently not risk-bearing; they get paid a percentage of the take; and b) they can pass the costs on in the form of higher premiums. The ACA won’t change that.

    The only people who care are those without insurance, a relatively small and uninfluential group, and those who actually pay the freight.

  • jan

    “The only people who care are those without insurance, a relatively small and uninfluential group, and those who actually pay the freight.”

    We’ve always have carried a high deductable, catastrophic kind of health insurance — with no attached riders for dentist, vision or Rx. Basically we pay for our own annual health services, unless they involve seriously over the top kind of problems. This makes our family health conscious and very cognitive of wise expenditures when we do seek medical help. It also makes us an odd-ball in society, as I find few people like ourselves who do this.

    You’re right about insurance shielding people from costs, especially when these people have the type of coverage where every small malady, exam etc. is covered, with no or low co-pays.

    Doctors also have to cover themselves from lawsuits, absent any real tort reform. Consequently, they often times go way out of the ‘standard of care’ bounds, in order to insure themselves of having no financial repercussions, because of being seen as ‘not doing enough.’

  • steve

    Most insurance is through employment. Employers should care, but they dont seem to very much. Insurance has been changing most plans have significant deductibles and/or co-pays now. Has not changed things much. Remembering the demographics of health care spending, it kind of makes sense.


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