Obamacare paying bonuses to DRs and Hospital to NOT treat people

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ACA 'Savings': Paying Doctors And Hospitals Bonuses To Deny Care To Patients

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the ACA calls for the federal government to pay physicians and hospitals bonuses if they deny health care to seniors and the disabled – and even encourages them to form local monopolies to make it harder for them to find alternative sources of care. And most patients won't even know that's the reason they are being denied care.

Section 3022 of the ACA establishes the Medicare Shared Savings Program (MSSP). The MSSP establishes the notion of Accountable Care Organizations (ACOs). These are groups of health care providers (hospitals, physicians, other providers) who join together for purposes of a obtaining bonus payments based on their participation in the MSSP and Medicare fee-for-service incentive program.

ACOs are paid to “reduce costs” for treating their patients. This sounds like a reasonable goal, but the ACO system has a number of odd and unique quirks. First of all, patients don't “enroll” in an ACO – they are assigned to an ACO ex post based on the preponderance of their utilization. That is, at the end of the year, if a patient happens to have had a plurality of care (measured by either service counts or dollars of Medicare claims), from physicians who are members of a particular ACO, then that patient is assigned to that ACO. (The methodology for assignment is detailed

here.) Not only do patients not enroll in ACOs; they might not even be aware of them, as assignments may take place after the fact.

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