Have you ever noticed that just about everything the government touches gets turned into a steaming pile of jelly beans?  Maybe I am exagerrating, but my friend and health IT guru John Lynn over at EMRandHIPAA.com had a comment conversation back and forth with me about Accountable Care Organizations (ACOs) recently.  After a post by Neil Versel, I mentioned that my beef with ACOs derives partially from their unformed nature and lack of concrete details.  How is anyone supposed to be convinced this isn’t just a government-run HMO?  How many patients do you know who love HMOs?

I told John “I suppose that that is a blessing, since without details, there can’t be any implementation.”  But then he correctly asserted, “Until you learn that they’re holding you to all the details for which they didn’t define or make known.”  Which is true!

And that’s exactly what happened to me when I tried to participate in PQRI for 2010.  What did I get for it after investing a lot of time and sweat as it required an extra form to be filled out at the end of already long and complex visits with my Medicare patients?  I get no one who will tell me or my practice manager any useful information other than the “program” is still “crunching the numbers” and will not be done doing so until late in 2011.  Although they are supposed to be able to provide an advance report on how much data I correctly fed into their system, the report is not accessible due to a lot of red tape and hoops to jump through (which in the end you find out are insurmountable).  As my last example and point for this post, it took my manager about a week on the phone to figure out that the advance report would be virtually impossible to get at this point.  It would be so much better if government incentive programs were properly formed before they went live.

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.