Why so much Anti-Trump stuff?

[Greenbeard]

The ACA mandates things, but addresses nothing in the way of COST of healthCARE.

This statement betrays a certain cluelessness about the subject. It reshaped incentives for the consumer and providers, which means the organization of the delivery system is changing. Now providers benefit if they can figure out ways to more effectively deliver lower cost care. Which means the private sector is opening up all sorts of lower cost sites of care, like retail clinics.

Shock treatment: A wasteful and inefficient industry is in the throes of great disruption

Less widely appreciated, but at least as important, are the incentives and penalties the law introduced to make the country’s hideously expensive and poorly performing health services safer and more efficient...

One of the biggest shifts under way is to phase out the “fee for service” model, in which hospitals and doctors’ surgeries are reimbursed for each test or treatment with no regard for the outcome, encouraging them to put patients through unnecessary and expensive procedures. Since Obamacare they are increasingly being paid by results—a flat fee for each successful hip replacement, say. There are also incentives for providers which meet cost or performance targets, and new requirements for hospitals to disclose their prices, which can vary drastically for no clear reason.

So for minor ailments and simple tests, it makes sense for such patients to go to one of the increasing numbers of walk-in clinics, staffed by well-qualified nurses, on the premises of retail pharmacies such as CVS and Walgreens...For injuries and illnesses that are more serious but not immediately life-threatening, lots of “urgent-care centres” are being opened as an alternative to going to a hospital emergency unit. Private-equity firms are pouring money into independent chains of centres. Merchant Medicine, a consulting firm, reckons that between them, these chains now have just over 1,500 urgent-care centres, up from about 1,300 at the start of 2013. The market is still fragmented but a national brand could emerge from one of the largest chains, such as Concentra or MedExpress.

Some hospital operators, seeking to cut their costs of care, and choosing to be among the disrupters rather than the disrupted, are also opening urgent-care centres. Aurora Health Care, a Wisconsin-based chain of hospitals and clinics, now has more than 30 of them.

Hospital operators are now facing a classic “innovator’s dilemma”, as described by Clay Christensen, a Harvard business professor. If they persist with their high-cost business model even as their customers discover that cheaper alternatives are good enough, they will be in trouble. According to Strata Decision Technology, an analytics firm, many hospital groups saw what was coming and started to cut their costs well before the provisions of Obamacare started to bite. One of the fastest movers is Advocate Health Care, a hospital operator from Illinois, which says it now earns two-thirds of its revenues from value-based payments.

These incentives are changing the way new hospitals are designed, such that there's a greater focus on cost effective outpatient capacity:

And with its emphasis on preventive treatments, with its new urgent-care center and outpatient and public health clinics, the new MLK campus, he says, provides a state-of-the-art answer to the question: How do you build a hospital in 2015? Or, as others put it, how do you build a hospital for the era of Obamacare?

County officials realized, for example, that many of the patients who used to visit MLK'S emergency room came in for psychiatric illnesses, so they opened an urgent-care psychiatric center last year. There's also an expanded outpatient clinic and a public health center where patients can get such services as immunizations and STD testing. A recuperative care facility — for patients who need a long-term place to recover from an illness — is set to open in the fall...

Belson says that nationwide, the administrators who are reimagining hospitals are focused on efficiency as never before. "It's not just L.A. or Martin Luther King by any means," he says.

Under changes outlined by the Affordable Care Act, hospitals and doctors' payments are based more on keeping patients healthy. For instance, providers are paid a lump sum to take care of a patient over a period of time, so they profit when they prevent patients from getting sick, avoiding expensive care.

 

[GottaGo]

This statement betrays a certain cluelessness about the subject. It reshaped incentives for the consumer and providers, which means the organization of the delivery system is changing. Now providers benefit if they can figure out ways to more effectively deliver lower cost care. Which means the private sector is opening up all sorts of lower cost sites of care, like retail clinics.

Shock treatment: A wasteful and inefficient industry is in the throes of great disruption

These incentives are changing the way new hospitals are designed, such that there's a greater focus on cost effective outpatient capacity:

Cluelessness?

In store clinics are not what was in the PPACA. Those are wholly separate from what was to be provided by the government, supposedly paid for my the additional revenues generated from penalties and taxes on medical devices.

Perhaps you have no issue with being required to by a private industry product, and that's just fine. But considering what the ACA has failed to supply, and promised on false information, shows in how many insurers are dropping out, and how the rates have skyrocketed.

The 'cost effective' may be for the hospital, not for the insured, or the insurers. As I said before, unless you yourself have gone through a major illness or injury, you have no idea about what this has cost the population in both care, and cost.

 

[Greenbeard]

In store clinics are not what was in the PPACA. Those are wholly separate from what was to be provided by the government, supposedly paid for my the additional revenues generated from penalties and taxes on medical devices.

The ACA was designed to reshape the market: make consumers more price conscious, make providers more cost conscious, support the reorganization of care delivery to get better results and slow the rise in costs. And that's why the market is changing. Providers are opening lower cost sites of care and finding more efficient ways to either deliver care or keep people healthy. You seem upset that it's spurring the private sector to open more clinics and only directly put $11 billion in federal money into building and expanding public community health centers.

The bottom line here being that it's absurd to say it didn't address the cost of care delivery itself. (I do like the instantaneous shift from "it doesn't do anything in the way of addressing the cost of health care" to "maybe it's making hospitals more cost effective but...").

 

[GottaGo]

The ACA was designed to reshape the market: make consumers more price conscious, make providers more cost conscious, support the reorganization of care delivery to get better results and slow the rise in costs. And that's why the market is changing. Providers are opening lower cost sites of care and finding more efficient ways to either deliver care or keep people healthy. You seem upset that it's spurring the private sector to open more clinics and only directly put $11 billion in federal money into building and expanding public community health centers.

The bottom line here being that it's absurd to say it didn't address the cost of care delivery itself. (I do like the instantaneous shift from "it doesn't do anything in the way of addressing the cost of health care" to "maybe it's making hospitals more cost effective but...").

It wasn't a shift. It doesn't do anything to address the cost of health care. The hospital may save money, but patients sure aren't.

There, does that help clarify?