Thursday, November 25, 2010

A Hippocratic Oath For Accountable Care Organizations (ACOs)

During it's post-Thanksgiving meal torpor, it occurred to the Disease Management Care Blog that it recited the Hippocratic Oath upon graduation from medical school. Since modern scientific policymaking has ascertained that goodly medicine should be a team sport, the agreeable DMCB wonders if other members of the health care community would want to demonstrate similar allegiance to the art. It is in that spirit that the DMCB offers up a version of the Oath for the newest member of the health care family: Accountable Care Organizations (ACOs):

I swear by CBO, the scorer, Hopefulius, Prayitworkius, and Panacea, and I take to witness all those who testify, publish and make presentations based on assumptions and made-up stuff, to keep according to my ability and my judgment, the following Oath and agreement:

To consider dear to me, as my parents, CMS who will regulate this art; to live in fear of its Administrator and, if necessary, to share upside risk with him or her; To look upon his or her regulations as my own siblings, to not rock the boat lest I be tossed under the bus or have to respond to a hostile letter from HHS Secretary Sebelius.

I will hustle for bundled payments for the good of my patients according to my ability and my judgment and avoid expensive MRI scans and other non-evidence based priceyness for everyone.

I will not give in to anti-trust allegations, nor will I document if I have made such a plan during meetings; and similarly I will not give an FTC lawyer any testimony to prompt scrutiny. But I will preserve the purity of my cash flow and my not-for-profit operating surplus.

I will not exceed my budget, even for patients in whom disease is manifest; I will meddle in all operations to be performed by practitioners, specialists in this art.

In every house where I come I will enter only for the good of gainsharing, keeping myself far from all appearance of any intentional ill-doing and all seduction and especially from the pleasures of finally controlling doctors, be they salaried or slaves.

All that may come to my knowledge in the exercise of my electronic records or in daily flow of information, which ought not to be shared with other competing providers appearing on area billboards as “Top 100,” I will keep secret and will never reveal.

If I keep this oath faithfully, may I enjoy my life and practice my art, be mentioned in glowing Congressional testimony or a State of the Union address and in all times; but if I swerve from it or violate it, may all my assets be absorbed by a for-profit investor owned health care system.

Once the regulations get published and the ACOs get selected for the national pilot program, the DMCB looks forward to seeing the Oath administered to the suits at an appropriate White House ceremony.

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