Physicians are at the center of all payments, delivery reforms and other letters

Regarding the recent article "Inspecting the role of the physician in ACOs" (ModernHealthcare.com, April 4), based on a new study in Health Affairs, I'm surprised that this topic just surfaced. Physicians are at the center and the key to the success of all payment and care delivery reform.

And yes, in order to achieve meaningful change there needs to be a critical mass of attributed lives. This may require providers to align their Medicare ACOs with other Medicare Advantage value-based care arrangements.

Luis Rivera

Regarding the April 3 Data Points ("STDs rising, prevention funds frozen," p. 33), clearly, the battle is being lost. And with some strains being antibiotic-resistant, the chance of reducing infections is even slimmer.

Donald Bryant

Regarding the Vital Signs post "How not to fix Obamacare" (ModernHealthcare.com, March 27), competition in the health insurance markets isn't what many imagine since insurers compete not over rates and benefits, but over which company can insure the healthiest panel of patients. A public plan at the very least, or a single-payer system, is the most obvious solution, but rational discussion of other options would help.

Ted Almon

Regarding the editorial "Some benefits are essential" (March 27, p. 40) I respect the thoughtful column, however do not agree that all policies must contain all of those essential benefits. There are individuals who are educated and reasonably well-funded enough to know whether or not they need prescription coverage, maternity, mental health or substance-abuse care services. Purchasing a plan without those benefits used to keep the premiums down. I understand about pooling the risks, but I think the ability to purchase a plan that excludes these items for off-exchange buyers should be possible without penalty.

Nan Mulhollan

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