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First time I become aware of the ACO Medicare program was here today. Medicare can change for some of us without our permission. So I checked it out. We all should. Found d a list by state. Medical practice groups signing up for this new Trump advanced program. Here it is.
https://medicareaco.com/current-list-acos
secondwind
(16,903 posts)hlthe2b
(102,099 posts)rurallib
(62,373 posts)It links to an article in common dreams:
https://www.commondreams.org/news/2022/12/13/scandals-mount-so-do-calls-abolish-private-medicare-advantage-plans
Inside that article is a link to an article on Nation magazine:
https://www.thenation.com/article/politics/its-time-to-end-the-medicare-advantage-scam/
From what I am reading ACOs of themselves are not bad ideas. Please if someone else has a different interpretation please tell me. I see that the place I go is affiliated in some way with an ACO.
But there is an ACO called ACO REACH that appears to be a bad guy.
Apparently people who have Medicare Advantage can be assigned to ACO REACH without their knowledge or consent.
Please, please if my interpretation is incorrect correct me.
From what I am reading if you have real Medicare your will not be screwed with.
hlthe2b
(102,099 posts)rurallib
(62,373 posts)A new Medicare privatization scheme developed under President Donald Trump and now being expanded under President Joe Biden is forcing hundreds of thousands of seniors onto new private Medicare plans without their consent.
The development represents a troubling new dimension in the fight by corporate interests to privatize Medicare, the federal health insurance program for people 65 or older. Medicare Advantage, which allows for-profit health insurers to offer privatized benefits through Medicare, already results in unexpected costs for routine procedures and wrongful denials of care. Private plans have cost Medicare an astonishing $143 billion since 2008, and are now driving some health insurers record profits.
The new Direct Contracting Entity (DCE) program similarly adds a private-sector third party between patients and Medicare services. Medicare allows these intermediary companies to offer unique benefits, like gym membership coverage. But as for-profit operations ranging from private insurers to publicly traded companies to private equity firms, these intermediaries are incentivized to limit the care that patients receive, especially when they are very sick.
While Medicare Advantage patients choose to sign up for private insurance plans, patients are being enrolled in these DCE health care plans without their informed consent. As Rep. Pramila Jayapal (D-Wash.) noted in a January op-ed, Seniors in traditional Medicare may be auto-aligned to a DCE if any primary care physician theyve visited in the past two years is affiliated with that DCE. That means Medicare automatically searches two years of seniors claims history without their full consent to find any visits with a participating DCE provider as the basis for enrollment. (my bolding)
Sort version: If you went to a doctor in the past 2 years, even if you have traditional Medicare, If that doctor has enrolled in what is known as a Direct Contracting Entity (DCE) you could be assigned into a DCE without your knowledge or consent.
Be very careful.
hlthe2b
(102,099 posts)rurallib
(62,373 posts)Here is their take on it:
https://pnhp.org/direct-contracting-entities-handing-traditional-medicare-to-wall-street/
with a video of explanation (15 minutes):
rurallib
(62,373 posts)I wrote a post on this at blogforiowa.com last year and forgot most of what I wrote back then. Looks like I need to resurrect that post:
https://blogforiowa.com/2022/04/02/medicare-what-are-dces-and-why-should-you-care/
snowybirdie
(5,219 posts)Lots of articles, some intelligible.
https://www.yuvohealth.com/post/what-is-aco-reach-and-how-will-it-continue-the-evolution-of-value-based-care