Hey Suggestion for some of us more Radical AC Users.... Another group I stay half in touch with, IMP, Ideal Medical Practices had it annual Camp in the DC area. On the Monday following when Camp Broke, those who wanted to, stuck around an extra day to do a "Lobbying Day".... We couldn't make and now I wonder how it all worked out because if memory serves me correctly it was on one of the most insane days in recent DC history...
What was it that actually set back the "Offical" opening, ribbon cutting of the Dr. King Memorial? Was it some weather thing or a super bad news day, I can't remember now.... But it was a big enough thing to actual impact and change plans for some place as large as DC.... Now that I think about it, I believe it was the moderate Earthquake that cracked a few important buildings and historic sites inlcuding the Washington Monument Needle was closed down and sectioned off from the public... That was what it was...
I believe that Monday was the same day as what canceled it, or perhaps was the day that it eventually got re-scheduled for, so DC was a flippin' Mad House I'm sure as that was a huge happening. And being a small conference with members around the country much like ours (and we have a good amount of cross over between the two groups too I might add. Lots of IMP AC Users out there for Sure) it was not like they could follow the Dr King people's lead and reschedule everything as the hotel and meeting room were booked as were many hotels res there and in other surrounding places, plane and train tickets too I'm sure... So they had to just go with it the way it played out....
But I digress here. The idea of us similar in mind and purpose AC users who probably all come from fairly small practices who have that small, Anti-ACO (newest HMO on Steriods and in Lipstick, right?) and other HUGE, still divided care, double payments to the Big Boys for Facility Fees putting the small guys at a disadvantage for sure... Why not pay us for our Facililties at the same kind of rates and watch us finally have enough money to add nice furniture, more and better equipment, better digs and locations, more staff with better retention because we might actually be able to afford to pay them better and give them some sort of bennies that most of us can not longer afford no matter how much we might feel the good deed need to do if we only could afford it.... To me the WORST Part of ACO's is the concept of Our side suddenly being forced, by hook or by Crook to start sharing and absorbing "Risk" and cost sharing.... Since when does a Laywer absorb any risk except on a civil suit against a manufacturer kind suit? You divorce is your own risk, I simply advise and guide here... Too many variables to control and that are outside of my and your control....
Insurance Carriers charge prices to absorb and offset risk. That is the Business that they created for themselves and only they really have the law on their side and the means to properly assess and then start to charge, and are pretty much assured a profit then, even in the face of absorbing and backstopping health care risks.
IMHO, If we are not allowed to sell insurance straight up (the main state based barrier to docs creating even small or modest cost membership practices and patient panels, the states say we are in effect "Selling" helath insurance) then why are we allowed to be, almost being forced to start absorbing the "risk" without being really allowed a NO Fee Schedule, charge whatever we see fit, let us ALL Collude amoung ourselves and with the Carriers to, to finally have a proper handle on any and all of the potential variables and data that would then influence our pricing structure based upon the very real risks that we are now going to be exposed to????
We all LOVE AC and support the best of a Real Free Market that has now been badly tilted against the likes of AC and other smaller, leaner, more efficent and Reasonably Priced Products... All this excessive money really was corporate Welfare for the NextGen's of the world, at the expense of products, vendors like Jon and AC who were kicking their butts by providing a decent product, that was super user friendly and at a price that was just about impossible to beat.... I bet most of us really don't want to have to cough up Medical Records and Open Up our data to "Prove" how meaningful we all are or that we actually "Improved" our outcomes based upon one or two semi-randomly chosen, or chosen with some intent but not very much or great science, not yet really proven to be completely valid Metrics like A1c's for DM... With disregard for the rest of the patient and the balancing games most of you have to play especially with very sick and or older patients. Many of these measures need to be balanced out against others...
Heck Bert could even bring along his $12 and change Maine Caid or Care, (State of Maine based Medicaid) check for his wasting an entire half a day or full day (what was it again???) for his "Expert" witness testimony in one of his patients cases... Now that is a deep sign of respect and appreciation for the full force and wide reach of a professional's knowledge and expertise if I have to say so myself... Take a bow Bert. The state of Maine really values you and your expert opinion, the time spent preparing, predeum for traveling, time spent away from your "Viable" practice and your patients....
What I'm saying is that between the lot of us, we sure as heck have more great stories and real live in the trenches facts about what kind of insane and unacceptable garbage we all put up with than any AAP, AAFP, AMA lead group of overfed and overpaid, disconnect lobbyists every could and would put forward. This should include ending the strangle hold on Office Visit and other forms of Cognitive Medicine E&M fees created by the AMA and their answers to nobody RUC.... If I walk like a RUC, and Looks like a RUC and Smells like a RUC, and talks like a RUC, then I would have to assume it must be a pretty pucked up RUC.
What say all of You???? Night ya'll.
Paul
