Medicare and ACOs

In my October post, I shared with you the conversation I had with my son about the Obama administration’s health overhaul, and how it was beneficial to our family. The 18-month-old law, and the actions that the governor of Florida has taken recently to oppose its implementation, has raised some questions from other family members in Florida.

I have been married to Michaelann since 1978, and I am as close to her parents as I was to my own. Both my mom and dad are deceased, but I still am very fortunate to have my mother-in-law and father-in-law in my life. They are both in their eighties, and they depend on me to answer many questions about their benefits under Medicare and the supplemental insurance they carry.

My father-in-law follows current events religiously, and during one of our phone conversations earlier this month, we had agreed to spend some time discussing the new changes in Medicare when they came up to visit for the Thanksgiving holiday. We were going to review the new legislation and discuss how it would improve their access to better healthcare.

Unfortunately, because of some health challenges my father-in-law is having, their doctor recommended they cancel their trip so they could be close to their doctor and hospital. It was a good thing they took their doctor’s advice, since my father-in-law was admitted to the hospital the Sunday before Thanksgiving. He was not discharged until Thanksgiving eve.

I know one of the recent news items that has caused some angst for my in-laws is the recent statement by Governor Scott of Florida when he commented on the Affordable Care Act.

“It’s not the law of the land; I don’t believe it will ever be the law of the land.”

During the phone conversation, I took the opportunity to remind my in-laws of the statement by the President when he signed the Affordable Care Act into law.

“This new law recognizes that Medicare isn’t just something that you’re entitled to when you reach 65; it’s something that you’ve earned. It’s something that you’ve worked a lifetime for, having the security of knowing that Medicare will be there when you need it. It’s a sacred and inviolable trust between you and your country. And those of us in elected office have a commitment to uphold that trust – and as long as I’m President, I will. And that’s why this new law gives seniors and their families greater savings, better benefits and higher-quality healthcare. That’s why it ensures accountability throughout the system so that seniors have greater control over the care that they receive. And that’s why it keeps Medicare strong and solvent – today and tomorrow.”
– President Barack Obama, June 8, 2010

As I told my father-in-law, the Affordable Care Act includes a series of Medicare reforms that will generate billions of dollars in savings for Medicare and strengthen the care Medicare beneficiaries receive. The new law protects guaranteed benefits for all Medicare beneficiaries, and provides new benefits and services to seniors on Medicare that will help keep seniors healthy.

The law also includes provisions that will improve quality care, develop and promote new models of care delivery, appropriately price services, modernize our health system, and fight waste, fraud, and abuse. Implementing these changes extends the life of the Medicare Hospital Insurance Trust Fund by 12 years from 2017 to 2029, more than doubling the time before exhausting the Trust Fund.

I also explained to my father-in-law how the Affordable Care Act promotes team-based healthcare through accountable care organizations under the Medicare shared savings program. We talked about ACOs that create delivery systems to encourage and support teams of physicians, hospitals, and other healthcare providers to collaboratively manage and coordinate care for Medicare beneficiaries.

I explained that if these providers meet certain quality and efficiency benchmarks, they might receive a share of any savings from reducing duplicative services, improving productivity, minimizing paperwork, or otherwise ,improving cost efficiency.

I tried to reassure my in-laws that the Federal government will continue to provide their healthcare under Medicare no matter what the Governor says. We plan to visit with them later this month during the Christmas holiday and spend some more time discussing accountable care organizations.

My question this month:  Does anyone know of ACOs in the Margate, Fla. area?

If so, I’d like to share the information with my in-laws.  Maybe, they can become one of the first members there?