As a retired RN, a traditional Medicare consumer and member of HealthCare for All WNC, I contacted my local doctor about the practice working with an ACO REACH program.
A little history first. During Trump’s presidency, the Centers for Medicare & Medicaid Services started a DCE (Direct Contracting Entity) pilot program. In it, Medicare automatically assigned beneficiaries to a DCE if their primary care physician or the physician practice joined a DCE. The only way beneficiaries could opt out was to find a different primary care doctor.
This year, CMS responded to criticism of DCEs with a name change: ACO REACH. ACO stands for Accountable Care Organization and REACH stands for Realizing Equity, Access and Community Health. These are great names that disguise their true intent, which is to privatize Medicare by 2030. I am entitled to the Medicare I receive because for the 50-plus years I worked, I have been paying into it. By privatizing Medicare, the Congress and President Biden are stealing the money I (we) put aside for health care in our aging years!
Here is how it is happening:
• Instead of paying doctors and hospitals directly, Medicare will give third-party REACH middlemen a monthly payment to cover some or all of each senior’s medical expenses, allowing these entities to keep as profit what they don’t spend on care. This establishes a dangerous financial incentive to restrict and ration care.
• Under this program, up to 30 million seniors who actively chose traditional Medicare may be automatically “aligned” with a REACH entity without their full knowledge or consent.
When I reached out to the Asheville practice, I was told they were independent and that it is not possible to change a beneficiary’s Medicare without their consent. Clearly, I was educating the billing person and will contact the board of directors, as I don’t know what the independent practice’s plans are.
I quit working with my orthopedic surgeon when his independent practice joined Mission/HCA. I hope that my primary provider’s practice doesn’t go in that direction.
I am hoping others in our community question their doctors. We really need a single-payer system. A transparent system where the patient chooses who they work with based upon their needs, not employer or insurance company decisions. Health care decisions belong between the patient and the doctor, not the insurance industry. The federal government would pay for the services through our taxes. Just like our taxes fund the fire department, libraries, roads, public schools and police departments. It will save us money and be equitable.
— Padma Dyvine