In Part 1, I pointed to a problem for Optometry as a whole, a shortfall of aggressive leadership in going after what Health Care Reform is all about. Health care is transforming. It’s a new game with all-new rules. With or without stimulus incentives and regardless of your Medicare or Medicaid volume, the new game in health care is about the survival of your business.
Let’s take for example the November publication by Blue Cross Blue Shield. Here is private insurance publicizing “What the Government Should Do”. Interesting, is it not, that CMS published its long-awaited Final Rule for Accountable Care Organizations (ACOs) only after the BCBS document had been officially released? There’s no longer room for the mentality that ARRA and HITECH don’t matter if you don’t do much Medicare. Sure, Medicare sits front and center but make no mistake: this is health care reform not Medicare reform and every payer, government or private, is getting in on the new game.
As called for by the federal reform law, the ACO program is intended to encourage networks of providers to collaborate on care for Medicare beneficiaries, with the aim of improving outcomes and reducing costs. A key element in this agenda is the patient-entered medical home model, which will effectively control access to patients in order to ensure better outcomes and lower cost. Providers who are not embracing EHRs, not paying attention to their state-based HIEs and not engaged in the discussion about ACOs are losing ground on key “survive and thrive” issues that apply every bit as much to Eye Care Providers as to Primary Care Physicians.
Alistair Jackson, M.Ed.
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