Summary
It would seem that at least until September 15 (the deadline imposed by Max Baucus, D-Montana, and Chairman of the Senate Finance Committee when there will be a vote on the legislation crafted by that time with or without Republican support), national healthcare reform is being held hostage by a "Gang of Six" U.S. Senators--sometimes known in recent military lingo as the "Coalition of the Willing". The other 529 members of Congress appear to be mere pawns in the process until that fateful day
Analysis
Other than how to pay for what amounts to around $900 billion over 10 years at this point in the sausage making process by the Senate Finance Committee, the big sticking point delaying production of a bill on which to vote is whether to include a public insurance option. Although the latest version does not include the kind of public insurance option which the President supports, there is still ongoing debate concerning whether to include one at least as a fall back provision should the compromise measure creating consumer/provider owned cooperatives not produce sufficient savings by providing real competition to the private insurance industry.
However, there is another provision in the current Senate Finance bill which has received relatively little public airing--the creation of accountable care organizations that would create strong financial incentives for physicians and others to work more cost effectively in collaborative teams. Accountable care organizations, in combination with bundling of hospital and physician payments, creating incentives for more primary care and the patient centered medical home, and using the results of comparative effectiveness research in a value based purchasing environment, could create (finally) the competitive environment necessary to bend the cost curve sufficiently to cover the uninsured and decrease the deficit long term even without the need for a public insurance option, or even cooperatives.
Because these provisions may best meld Republicans' belief in the virtues of private sector market competition to continuously increase consumer value and Democrats' belief in the virtues of more primary care and improving the access to affordable, high quality care, accountable care organizations may well prove to be the only possible bridge to achieving even a minimally bipartisan bill which can pass both Houses of Congress in the Fall.
Companies poised to benefit from the rise of Accountable Care Organizations would include those focused on standards based quality and cost effectiveness analyses of large population health databases such as:
1. Premier, Inc.
2. CSC;
3. IBM;
4. Accenture;
5. Hewlett Packard
This author consults with leading institutions through GLG
Analyses are solely the work of the authors and have not been edited or endorsed by GLG.
