A few days ago Jim Fuquay a writer for the Star-Telegram in Ft. Worth Texas wrote an article entitled “Texas Health Resources withdraws from Medicare’s Pioneer ACO program.” You may ask what does an action by a health resource and big physicians groups in Texas have to do with my state or my personal health insurance? Believe me it will affect your health coverage.
What is happening in Texas can and probably will occur in many of our states.
Simply stated the two groups involved, Texas health Resources and a major physicians organization, North Texas Specialty Physicians partnered in Plus ACO, an accountable care organization that joined the Medicare Pioneer ACO program in December 2011. The agreement is in essences to achieve savings with both organizations sharing in any savings and of course in any losses accrued to their patient base.
While Plus ACO is on pace to save $10 million annually they are looking at penalties in 2013 of between $6 million and $9 million and they will avoid those penalties by pulling out of the company.
The cause of this problem and decision by this major health group is the result of quality and cost benchmarks used by Medicare to determine ACO’s performance.
ACO’s facing performance guides by Medicare are likely to withdraw from the ACO services and further weaken the over all performance of the countries health services. This means another loss for the ACA.