Today I’m going to focus on Accountable Care Organizations (ACO’s). This past week, CMS announced their initial rules and regs for ACOs. Start with the basic: what is an ACO? It is an organization to be formed by hospitals, doctors and ancillary service providers to better manage the care of Medicare patients. Think of the Mayo Clinic among a set of providers without common ownership. The goal is to actually manage the care of a patient (boy does that sound familiar!!) in order to get the optimal outcome at the lowest cost. The ACO then shares in a portion of that cost savings. This is yet another experiment in trying to find out how to insure that patients get the care they need in a system that pays providers for every time they provide care. The system we have gives every healthcare provider the incentive to provide services, whether needed or not. The system also gives incentives to get MRIs, use drugs and do a large variety of things that adds profits to someone’s bottom line, but doesn’t necessarily improve and may in fact reduce the quality of health care. CMS has been trying to figure out why healthcare might …
The Real Estate Guys
Robert, Russ — Great to be on your show talking about St. Kitts and the opportunity to create a medical school and healthcare delivery system in the Caribbean. I look forward to being with you next month in Belize to check out the healthcare system there and to meeting you and your clients on St. Kitts in April 2011. The Real Estate Guys are sponsoring a cruise focused on real estate investing in April. Their last stop is in St. Kitts and we will meet the ship and personally escort his clients to see this great island nation. Check out The Real Estate Guys at www.realestateguysradio.com. My interview was broadcast on July 25th — click here to listen to the show. Thanks guys — we have a conference call in 30 minutes — look forward to speaking again. Jeff Check out the St. Kitts Project tab at the top of this page !!!!! You a doctor? At the bottom of the St. Kitts Project tab page is a link just for you, or you can Click Here. Be part of what could become the most amazing adventure in the Caribbean.
Thank You Freedom Fest 2010
Last night was the conclusion of Freedom Fest 2010 at the Bally’s Casino in Las Vegas. The quality of this program was astounding and I congratulate all who were involved. You haven’t lived until you see Steve Forbes dressed up as George Washington in one of the skits at the closing banquet. We live in unique and dangerous times. As I’ve written to my clients on all too many occasions, the investment decisions that we make in the next couple of years will be the most decisions that we will ever make in our lifetimes. Get it wrong and we may be financially ruined, regardless of how many financial resources we have today. Get it right and even modest investors can make millions, securing the financial future for their families today and for generations to come. If you have never heard of Freedom Fest, click on this link and see what you missed. Something like 160 presenters over three days. I’ve been to lots of conferences and heard lots of speakers. The quality of the speakers at this conference was impressive. And the conclusion is unmistakable: the United States and most of the major countries around the world are on …
Healthcare Reform Signed – Watch Out Below
The deed is done. Obama’s version of healthcare reform is law and the details continue to trickle out. My favorite so far is that consumers will be fined $695 to not get insurance — the IRS will keep tabs, but the IRS hasn’t been given any money to enforce the bill (estimated at >$10b annually) — and the IRS has been given no enforcement ability. People who don’t get insurance will be billed $695, but if they don’t pay, then the IRS can’t take the offender to court, doesn’t charge interest or penalties — in essence, the IRS has no power to collect. While stupidity like this kept the cost of the bill down for the CBO, ultimately money will need to be added and the deficit will grow larger. With the deficit in mind, last week’s US government bond offering went poorly and interest rates ticked up 10-20 basis points. Increases in interest rates has begun and the market, not the Fed, will push rates higher and ultimately the Fed will be pulled along. If someone needs to pay $150/month for insurance, it seems to me that paying $695 in a fine (assuming the fine actually needs to be …
A Major Week in the History of the U.S.
This coming week may be a major milestone in the history of the United States. The Administration will pull out ALL stops and will do ANYTHING to get their version of the healthcare bill passed. First let’s review the procedures for passage. A couple of months ago the House and Senate passed different versions of the reform bill. Given that the Senate could not pass (by 60 votes) the same bill today, the House needs to pick up the Senate bill and pass it without amendments. The House does not have the votes to pass the original Senate bill, unless they cut a side deal with the Senate. With a side deal in place, the House intends to get the votes to pass the original Senate bill and that will be signed by the President. The deal with the House is that the Senate will introduce another bill to make some budget changes to the original bill, and will move to pass this new bill with the 50 vote reconciliation process of the Senate. The purpose of this new bill is to adjust the final version of the original act, which is necessary to get the House votes necessary for …