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Accountable Care Organizations: Will They Live Up To The Hype?

by Barbara J. Zabawa, posted Tuesday, May 17, 2011

On Thursday, May 11, 2011, I had the pleasure of talking to the Wisconsin Medical Group Management Association about Accountable Care Organizations (ACO). It was truly a pleasure to discuss what I believe to be the future of health care delivery. I answered the question: “Will ACOs live up to the hype?,” in the affirmative. I believe that ACOs offer a sensible way of providing care in light of the forthcoming changes from the Patient Protection and Affordable Care Act, should the U.S. Supreme Court find the Act constitutional.
Regardless of the U.S. Supreme Court’s forthcoming decision, however, I believe the ACO movement is still worth health care stakeholder consideration.
During the presentation I described the current landscape of negotiations between providers and payers, and informed the audience as to how ACOs and other parts of the Affordable Care Act will ease the current tensions and help these stakeholders work toward the common goal of providing patient-centered care. Because insurers will have less flexibility in increasing premiums, insurers will not be as willing to accommodate provider cost increases. Therefore, providers and payers will be forced to find alternative ways to work with one another. I believe an attractive option is through the ACO vehicle.
The ACO holds the promise of delivering appropriate, seamless care to patients. The ACO concept embodies the other, much less-discussed piece to the Affordable Care Act that strives to improve health care quality and efficiency.
I invite you to look at my presentation materials on ACOs. I am certain there will be more blog postings on this topic soon.

In re Helen E.F.: Good Intentions Gone Wrong?

by Barbara J. Zabawa, posted Monday, May 16, 2011

Image “One way to measure the greatness of our society is to look at how we treat our weakest members, such as our growing population of people afflicted with Alzheimer’s.” That is a quote from a recent Wisconsin Court of Appeals decision that, although well-intended, may ultimately harm patients suffering from Alzheimer’s disease and related dementia disorders. On April 27, 2011, the Wisconsin Court of Appeals issued an opinion concluding that people suffering from dementia and Alzheimer’s disease should not be subject to Chapter 51 commitments because such conditions are not “treatable.”  In re Helen E.F., 2010 AP 2061 (Ct. App. April 27, 2011). In that case, Helen E.F., an 85-year-old woman with Alzheimer’s dementia, was committed to St. Agnes Hospital pursuant to Wis. Stat. ch. 51 because of her disruptive behavior. Id. at ¶ 9. Three days later, a court commissioner conducted a probable cause hearing on the ch. 51 petition. Id. at ¶ 6. The court commissioner concluded that there was insufficient probable cause to proceed. Id. At that point, the ch. 51 proceeding was converted to a Wis. Stat. ch. 55 protective placement action and a 30-day temporary guardianship was issued. Id. Read more...

ABA Fights Implementation of the FTC's "Red Flag" Rules

by Christian D. Lavers, posted Monday, August 31, 2009

Image On Thursday, August 27, the American Bar Association filed suit against the Federal Trade Commission to prevent application of the FTC's new proposed "Red Flag" rules to lawyers and law firms (See the complaint at www.abanet.org/media/nosearch/1). The "Red Flag" Rules require that any business or entity that acts as a "creditor" create a policy and procedure to help prevent identity theft—even if the business is only acting as a creditor by billing for goods and services after the services are rendered or the goods are provided.
The FTC has had numerous problems in its attempted implementation of the rule, and recently postponed enforcement of the rule to November 1—its third such postponement. The problems have related to the incredible breadth of the rule, and its application to virtually every business and industry in existence.  The American Medical Association has also been a vocal critic of the rule as applied to doctors, (see www.ama-assn.org/ama/no-index/physician-resources/red-flags-rule.shtml), though they have not gone so far as to file a lawsuit.
While identity theft is a growing problem and needs to be addressed, the current version of the "Red Flag" Rules creates almost as many problems as it attempts to fix. Stay tuned for updates...