The Art and Riches of Value-Based Care: A Malevolent New Medical Pseudoscience

The American Medical Money Machine ^ | July 17, 2015 | TAMMM Staff

[Rona Badger]

Chasing bigger profits, the insurance cartel has now come full circle to embrace pseudoscience wholeheartedly. From deep inside the inner workings of the giant insurance companies comes the very antithesis of fact-based statistics and research: Value-Based Care. Though the concept has been brewing for more than a decade, it’s now hitting the mainstream as the darling for determining how medicine and money will be dispensed. This impressive sounding term essentially justifies the biggest rip-off of all time.

Many doctors and physician assistants interviewed by TAMMM staff tell us they whiz through these forms, often putting blanket NOs for answers which a patient may not be forthcoming (or truthful) in answering or for which they are simply too embarrassed (or outraged) to ask you about.

Shouldn’t it matter to know just how reliable are these health records? Never mind. Based on the all-knowing electronic records, panels of government and insurance overlords are basing your future treatment on them. This is what their evidence-based practice embodies—using pseudo, unverified data as a basis for decision making about your costs and care.

The nobles take the pseudo evidence and spin out the rules for Value-Based Care. This now serves as the basis for how much insurance companies—or the government—will spend to treat any given patient.

In short, Electronic Health Records serve as the basis for Evidenced-Based Medicine. Evidenced-Based Medicine is used to calculate Value-Based Care models and outcomes. Value-Based Care models then serve as the basis for how much a given case is worth or, put another way, how much money will be assigned to price-fixed Bundled Payments!

This is dense stuff and it’s meant to be! Understanding the double-talk and rationalizations put forth by industry giant UnitedHealth Group and the government is paramount to unraveling this whammy.

[originalbuckeye]

The Government limiting the number of insurance companies is just as bad as Socialized Medicine. The Govt will just dictate the parameters to the big 3 health insurance companies and then, eventually limit them to one company. It’s coming.

[arthurus]

So a third party is to determine what is valuable to the individual. In a “value based” society there is no individual choice and one’s choices are determined by a committee or by an algorithm.

[Rona Badger]

Exactly. This article is one of the first that puts all of these terms in perspective. It is a little dense, but wow. I had no idea that this Slavitt was from Optum but it all makes sense when you follow the money. He worked at Goldman, too.

[Rona Badger]

In a “value based” society there is no individual choice.

I imagine this is a concept from European socialists that made it's way here. It probably goes back to Ancient Greek for that matter. People always meddle with the way things are done and sometimes that's great but most of the time...

[Rona Badger]

[buckalfa]

The theory of value based care or reimbursement is that a hospital's payment is reduced if it does not maintain certain "quality" of outcome standards or measurements. Sounds good in practice, but the problem is that quality is measured in paper work stats, not actually what is good for any individual patient because more effort is spent on charting rather than hands on patient care.

[glorgau]

The key is to realize for whom the “value” is being calculated.

[Rona Badger]

Right. This article says that if the hospital/doctors go under the allotted “bundle” amount, then they get to keep the difference. If they go over, they have to pay the difference. That is outrageous. Caregivers are now just like any other sales team where it’s pay for performance, meeting your “stretch goals” and working for incentive bonuses.

[Rona Badger]

Heh, right. I can’t remember anyone telling me, “go see this doctor, she’ll give you a great value.”

[Plain Old American]

Can you say “Death Panels”

[Plain Old American]

“basis for how much insurance companies—or the government—will spend to treat any given patient”

Can you say “Death Panels”

[Rona Badger]

Many laughed at SP when she warned about the death panels hidden inside of Obamacare. She was right then and she’s still right now. How does that go, you can call a fish by any other name but it’s still a fish...

[originalbuckeye]

So, it stands to reason that, if you’re really sick, they will be less likely to treat you. If the end result isn’t what the Govt expects, the hospital/doctor will be punished. Why am I not surprised??

[Trailerpark Badass]

For “us,” obviously.