Thursday, September 8, 2011

Mayhem and Downside Risk in Accountable Care Organizations

The channel-surfing Disease Management Care Blog routinely stops whenever its remote comes across any of the AllState "mayhem" commercials.  Humor aside, they're a smart portrayal of the unexpected downside of risk that can cruelly strike property owners anytime and from anywhere.

Refusing to be boxed into mundane homeowner or car insurance, the DMCB took media flight and applied the the idea of mayhem to Accountable Care Organizations.  Assuming most readers are familiar with the commercial, the DMCB suggests that the volume be turned down when the "play" icon is activated.  The paraphrased ACO dialogue is below.... 

I’m a raccoon and the Mayhem I represent is all the things that can go wrong for your Accountable Care Organization. I'll make this the worst fiscal year of your organization's life.

This fluffy stuff is all your carefully laid plans to make a lot of money. Oops, more inpatient admissions than you planned for! Four quality measures are already in the dumpster. Think all that wiring means you can get any useful utilization data out of your network?  Check out this hole in the roof where your return on investment with Medicare will disappear. And you will be paying for this yourself even if you don't get any shared savings.

So get real about easily saving money and think about Mayhem.... like me.

And lest we forget about what can happen if rank and file physician input is ignored by ACO leadership when they're making their big plans......

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