ACO is coming to Baptist Healthcare in KY – regular Medicare being covertly replaced ?

For those of you who forgot about what a ACO is… think back to Obamacare… that is what expected for various healthcare group would do… they would create something like a “sub-insurance company”… where the healthcare providers would banned together and create ACO who would agree to treat a certain group of pts for a fixed $$$/pt/month..
Baptist Healthcare        is able to provide just about everything in our ONE HOSPITAL COUNTY…  at first I thought – except pharmacy/medications – and then I remember that our local – sort of, being abt 8-10 miles away – hospital … took out their “gift shop” and put in a “retail pharmacy “… within “spitting distance” of the hospital is a 24 hr CVS, Walgreen & a Independent pharmacy and within a “stone’s throw” a Target/CVS pharmacy and a Kroger pharmacy.  that is about 1/3 of all the pharmacies in the county of a population of abt 85,000.
On thinking of this… a ACO could be sort of a Medicare Advantage Program… except a Medicare Advantage Prgm is a FOR PROFIT INSURANCE COMPANY contracting with various healthcare providers for care for the people that pay the insurance company monthly premiums. Is a ACO… healthcare providers basically becoming a “insurance company “. That term in their press release “coordinated care” concerns me… does that mean… once they get their “hooks into you”… you won’t get any care outside of their system/network ?
That is what CVS health has been trying to do… buying Aetna Insurance, Caremark PBM, Silver Scrips Part D, retail pharmacies, specialties pharmacies, mail order pharmacies, nursing home pharmacies. immediate care clinics in many of their stores.  If a pt has Aetna insurance, their insurance uses Caremark PBM or the pt has Silver Scripts part D… guess where CVS health wants the pt to get their Rxs filled ? I have heard of some of their programs that after a pts gets a Rx three times… unless they get them in the future from a CVS retail pharmacy or CVS Mail order pharmacy – the pt GETS TO PAY FULL PRICE… NO INSURANCE COVERAGE.
I suspect that what Baptist Health system is going is being cloned by many other similar healthcare organizations across the country.
I have noticed over the last couple of years… there is more and more TV commercials promoting Medicare Advantage programs…  Could Medicare doing a “end run” around those of us who do not want to sign up for a Medicare Advantage program and bringing around a “Trojan Horse” that we are being told that we still have traditional Medicare but one day wake up and we have basically a Medicare Advantage type prgm in place of traditional Medicare… because the FEDS will be able to control how much Medicare care costs… since they are going to be paying these ACO’s so many $$$/pt/month… The balance of the baby boomers will be on Medicare by the end of this decade.
Dear Valued Patient:
Baptist Health is committed to providing quality care, close to home for you and members of your family. You are receiving this notification because Baptist Health is a part of an accountable care organization, Baptist Health Care Partners, LLC.
An accountable care organization, also known as an ACO, is a group of doctors and other healthcare providers. These providers agree to work together with Medicare to help ensure you receive high-quality, coordinated care.
The Centers for Medicare & Medicaid Services requires Baptist Health to notify patients who are part of a traditional Medicare plan that your provider participates in an ACO.
Your health and well-being are important to us, and we want to assure there is no confusion about this notice. There are no changes to your benefits, and there is nothing that you need to do at this time.
Additionally, you still have the choice to visit any doctor, hospital or other provider that accepts Medicare at any time, just as you do now.
You can find more information on accountable care organizations enclosed with this letter. If you have any questions, call 1-800-MEDICARE.
Thank you for entrusting Baptist Health with your care. We look forward to continuing a healthy partnership with you.
Baptist Health

One Response

  1. Yes their ‘rap’ on TV never fooled me once. The so called “Medicare Advantage” certainly has at its end point MONEY, no matter how many times they holler “FREE”… And after this article it would not surprise me if CVS was not at the top and bottom of it… We will need our own doctors if the Marines will not come to our aid and squash these ravenous dogs at CVS.

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