Kathleen Healey, MD, spoke to us about ACO Reach. She is a retired otolaryngologist (ENT) whose medical career ranged from military service as a flight surgeon to solo and group practices in Napa Valley, California. She is currently co-chair of Physicians for a National Health Program-California Chapter and serves on the National Board of PNHP.
Kathleen told us that ACO REACH is a threat to the choice of medical coverage for seniors. It adds in third party to manage senior care and is similar to the Medicare Advantage. It is an experimental program that was developed by the Center for Medicare and Medicaid Services but does not require congressional approval. The goal of the program is to cut costs but may increase them. There is significant interest from Wall Street as they see profit can be made by maximizing the funds they receive from the government; minimizing the care that they give; and enrolling lots of people. Kathleen described process of up-coding, where Medicare Advantage programs and ACO REACH entities can receive more money. This creates the temptation to ration and restrict care, which already occurs with some Medicare Advantage programs. This new program may drain the Medicare trust funds faster as traditional Medicare is very efficient; 98 percent of funds go to care. Under the ACO Reach program, more money can be retained by the third-party companies. The program also allows patients to be automatically enrolled if their doctor joins a REACH plan. This undermines free choice under traditional Medicare. The plan is a step towards trying to privatize Medicare by 2030 with a thought towards saving money. www.protectmedicare.net has a petition that can be signed to support retaining the current Medicare program.