Learning from ACOs and other letters

About “Why one Medicare Pioneer ACO succeeded in saving money”, I really like this article. It is so easy to just listen for and repeat negative comments about the Pioneer ACO experience. I like to learn from a Pioneer and learn which activities have the greatest impact. Data, analyzing who is at risk, developing creative strategies to take care of the sickest people and keep them at home are the common reports from ACOs that have done well in the first year. Data, it seems, is vital. With all the electronic health records out there, it is still hard to get a decent report. Information technology and healthcare informatics are key.

Karin Roemers-Kleven

To hear the CMS spin is to hear what a success the accountable care organizations are (“CMS names ACOs leaving Pioneer program,”). The reality is you wouldn't have groups leaving the program if that were a fact. The fact is, quality initiatives are gaining and outcomes are improving, mostly because of better communications and health data information the groups have been reviewing from themselves. As far as savings, it's not happening. The costs of adding systems, on top of the systems in place, the extra reports, who determines the savings, and how they will actually be shared—it's all an outcome in motion and yet to show significant return for the investment made (hard cost and staff extra time costs). A few million dollars in reported savings is a long road from the trillions being spent in healthcare. But hey, it is better than a stick in the eye.

Dennis Gerber

Regarding “CMS names ACOs leaving Pioneer program”, I would be interested to know the demographic makeup around the successful Pioneers. If your surrounding community is not one that takes responsibility for personal health, I can see where your initiatives may not be successful no matter how progressive and “correct” they may be.

Guinness Collins

Regarding “WellPoint to pay $1.7 million HIPAA penalty”, WellPoint is just the tip of the iceberg. Since all of our personal phone messages, e-mails and Internet correspondence have been tapped into by the National Security Agency, why would we even be concerned about our medical information?

There is no longer any such thing even resembling privacy or a personal life. As an American citizen, I do not need another reality check to know that our private lives are no longer private. So what is a little HIPAA leak? Hardly seems worth our while filling out the forms!

Ann Quinlan

Regarding “AMA, Joint Commission release strategies to reduce overused treatments”, I think that the American Medical Association/Joint Commission symposium on overuse is a good step forward, as it helps focus hospitals on top opportunities for improvement. As an anesthesiologist who has spent the past 20 years focusing on better blood use, it is particularly gratifying to see that appropriate blood management made the list. Blood is a high-volume, high-risk, high-cost therapy that is poorly utilized, and the recommendations made by the working group are consistent with my experience in changing embedded and antiquated transfusion practices.

Dr. Timothy Hannon