in HIPAA Headlines by John Brewer

I’ve said before, I have nothing against ACO’s.

I do think it is important, though, to realize that chances are good that our Government will not be able to create an efficient business model…for anything.

I’m reminded of my time in the Air Force.

In the mid-1990’s somebody at a high level in the Air Force must have attended a 7 Habits of Highly Successful People seminar.  Additionally, in the business world, quality control and metrics were buzz terms.

Suddenly we were to track metrics for customer quality.

What?  I flew a “tanker”.  We “passed gas” while airborne to other aircraft.

In that realm, “quality” is being at the refueling point on time and passing  the verbally requested amount of gas.

Many times we (or they) had maintenance problems or weather that completely changed the game plan, though this only counted against your quality score.

Yet, the quality metric was whether we had an on-time takeoff and gave the “official” amount of fuel requested.

Now, you have a bunch of pilots tracking “quality” metrics that don’t mean squat in the end.

Add to that, we all attended 7 Habits seminars.

I’m not saying there is not room for improvement in the military, but the military, nor the government, is a business.  And most people in the military or government have never run a business.

Whew, back to ACO’s.

Today’s Wall Street Journal has an editorial about Accountable Care Organizations.

It is interesting.

I do take what the WSJ says, especially in the editorial section, with a grain of salt, but the over all idea of the government “creating” a business model is quite comical.

It does seem realistic to base a new business model on an existing model that is succeeding.

This is apparently what the HHS has done.

The ACO model has been designed around the example of 10 “high performing” physician groups.

The problem is, once the government stepped and documented how they wanted things to work, all 10 of the high performance groups now say they will be “…unable to participate.”

I won’t go into all of the details, but the problem with government writing rules and attempting to create a business model is not only are the “writers” of the rules typically without real world experience, they are also prodded by special interests to tweak rules.

In the end, you have a blob that doesn’t resemble the original idea.

It is my opinion, that until true supply and demand is allowed into the medical market place, we will never see things settle down.

If individuals knew exactly what they were paying for (no co-pays), with “their money” (a health savings account), you would see physicians start to market not only on price, but experience and outcome.

I’m not aware of a successful business model that is in place of which  the government conceived…I’d be glad to be enlightened.

If you have an example of a successful government created business model, be sure to post it in the comments below.

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