Now, eight months into the new law is a growing frenzy of mergers, the inclusion of hospitals, clinics and physician groups eager to share costs and savings and cash in on the incentives. You, in turn provided a small army of lawyers and lobbyists that try to convince Obama manage to relax or one body of older legislation intended to thwart healthcare monopolies and to waive to protect against shoddy maintenance and fraudulent billing of patients or Medicare.
Consumer advocates to resolve fear health which could aggravate problems very few law, it was meant by less competition, drive the cost and bonuses-saving incentives for doctors and hospitals to stint on maintenance costs to keep.
"" The new law is already promoting a wave of mergers, joint ventures and alliances in the health care industry, ", said Prof. Thomas L. Greaney, expert in health and competition law at the University of St. Louis."The risk that dominant providers and dominant insurer can exercise their market power was individually or together, never been greater."
Lobbyists and industry groups are bearing down on the Federal Trade Commission and the Ministry of Justice, which enforce the antitrust laws and the Inspector General's Office to the Department of health and human services, the ferret out Medicare was.
These agencies are known as accountable care organizations schreiben.Sie a tricky challenge to govern facing rules, the new entities: the potential benefits of the clinical collaboration with the need to enforce against fraud, abuse and antitrust laws load balancing.
"If accountable care organizations end rather than unleashing competition stifled,", said Jon Leibowitz, Chairman of the Commission trade, "we pass was one of the great opportunities for health care reform will have."
To encourage Congress which was purpose cooperation in a health system that notoriously fragmented modified.system hope was that the new law would push doctors, hospitals and other health care providers to come and share the responsibility for the costs and the quality of care of patients, especially Medicare beneficiaries.
Experts say, a network of care and better coordination between doctors and hospitals can benefit patients.
On Tuesday Obama management founded a Center for Medicare and Medicaid innovation, new ways of coordination and the payment for services, in addition to the accountable care organisations to test.
Hospitals have assumed a pioneering role in the emergence of these new facilities.
Johns Hopkins Medicine, which operates a hospital in Baltimore and 25 clinics in Maryland, has just acquired Sibley Memorial Hospital in Washington, 16 months after the acquisition of suburban hospital in Bethesda, MD.
"This largely is driven by the health system, which calls for an integrated regional network", said Gary M. Stephenson, a spokesman of the Johns Hopkins.
Kentucky three negotiate the largest hospital networks a fusion, partly prompted by the new law.In the three regional Federal permission to which health care systems are New York, merge, including hospitals, clinics and nursing homes in Albany and surrounding counties.
Come incentives for doctors and hospitals to cost and potential for Missbrauch.Judith A. Stein, Director of the non-profit Center for Medicare Advocacy to lower, with potential efficiency gains, said she was concerned that some care organizations would try, hold by the cost "cherry-picking healthier patients and care to refuse if it is required."
According to the law, Medicare can penalize organizations, patients with high risk, avoid high costs.
Peter W. Thomas, a lawyer for the Consortium for citizens with disabilities, a national advocacy group, concerned about the impact on patients.
"In an environment where the health care providers are financially rewarded for the costs keep," he said "who has a disability or a chronic disease who requires specialized or complex care, get access to appropriate technology, medical devices and rehabilitation don't worry muss.Sie want to save money on the backs of people with disabilities and chronic diseases."
Almost a quarter of the Medicare have represent beneficiaries five or more chronic Bedingungen.Sie two-thirds of the output from the program.
Elizabeth B. Gilbertson, chief strategist of one union health plan for hotel and restaurant employees, worried also care provider could cause the consolidation of health at higher prices.
"In some markets," Mrs Gilbertson said: "the dominant hospital as the Sun is in the middle of the Sonnensystems.Es has physician groups, surgery centers, laboratories and Apotheken.Rechenschaftspflichtig organizations bring care more planet in the system and strengthen the bonds between you, the entire entity make more powerful with an adequate means to increase prices."
She added, "This is a terrible danger."
Doctors and hospitals say that promise these organizations are not fully realized unless you get broad exemptions and exceptions to the Government.
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