Growth of Medicare’s ACO Reach Scam Halted

The program appears to be dying of self-inflicted wounds that were long predicted. Supporters stiffened their spines instead, ignoring the obvious blood loss.

The program appears to be dying of self-inflicted wounds that were long predicted. Supporters stiffened their spines instead, ignoring the obvious blood loss.

By

Gaudium Magnum

Now that 2.1 million Medicare beneficiaries have been involuntarily moved from their Traditional Medicare into the ACO Reach privatization scheme, the creation of any more such entities has been halted. A decent presidential administration would now offer an off-ramp to the victims of this outrageous assault on their vital health insurance programs. Unfortunately, the sole escape from this “Reach,” for all intents and purposes, is death.   

This from the President of Physicians for a National Health Plan (PNHP),  Dr. Phil Verhoef:

“As you may have heard, we won a big victory recently in our campaign against the REACH program, which has placed corporate middlemen in charge of the care of 2.1 million Traditional Medicare beneficiaries. The director of the Center for Medicare and Medicaid Innovation [CMMI]—the agency in charge of REACH—announced that the program had been capped and would not be accepting any more corporate applicants. This means they are projected to fall far short of their goal of moving everybody on Traditional Medicare to a REACH-like plan by 2030.”

Dr. Verhoef went on to describe this admission as a “stealth announcement” by the Center for Medicare and Medicaid Innovation. This confession came during the CalPERS Education Day gathering.

“In a speech given to the California Public Employees’ Retirement System (CalPERS) on January 17, Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler revealed that there are no plans to further expand the number of organizations or beneficiaries in the controversial Medicare REACH model.”

Liz Fowler fights off impending head explosion

I watched the video of the entire proceedings as Fowler bobbed and weaved through her pitch on the glories of ACO Reach. Throughout, she carefully avoided mention of the severe fiscal and health delivery problems with this privatization effort, ABOUT WHICH SHE HAS FULL KNOWLEDGE. Her evasive answers to questions from the CalPERS board members were a monument to the ability of political appointees to speak fluent argle-bargle, while simultaneously holding contradictory thoughts, without their heads exploding. Of interest in the CalPERS video was a presentation by Dr. Jim Kahn, Emeritus Professor of Health Policy, Epidemiology, and Global Health at the University of California, San Francisco. Dr. Kahn shredded Dr. Fowler's contentions by exposing the deliberate omissions, misstatements, and misrepresentations that are constantly being fed to the public about Medicare Advantage and ACO Reach. His riposte is well worth the time to watch and can be found at 2:54:00 on the video counter.

I invite readers to contact their legislators in Congress and President Biden to demand that these Medicare privatization scams be terminated permanently. While you are at it, contact Dr. Lorna Gober, recently announced as the new chief medical officer for PeaceHealth Northwest network, which includes St. Joseph Hospital here in Bellingham. Send a letter* to advise her that PeaceHealth moved thousands of their own patients, without permission or warning, into its version of ACO Reach.   Demand that she speak out against this greedy and deceitful move against those whose health and well-being has been placed at risk for the sake of profits. This is all the more incongruous given PeaceHealth's “non-profit” declaration. More on that here: “The Blob” or Peace Health’s Latest Expansion Gambit.

*2979 NW Squalicum Parkway, Bellingham, WA 98225

About Dick Conoboy

Citizen Journalist and Editor • Member since Jan 26, 2008

Dick Conoboy is a recovering civilian federal worker and military officer who was offered and accepted an all-expense paid, one year trip to Vietnam in 1968. He is a former Army [...]

Comments by Readers

M. Lynda Hanscome

Mar 13, 2023

You are SO right about ACO REACH scams.  I was one of the PeaceHealth Original Medicare beneficieries who was SECRETLY enrolled in the PH scam.  I am furious a year ago when I found out, and a year later, I am still furious.

Thanks, Dick, I will write the new PH head-of-state…

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M. Lynda Hanscome

Mar 13, 2023

Lorna Gober, MD
CMO, PeaceHealth
1115 SE 164th Avenue
Vancouver, WA 98683

Dear Dr. Gober:

Subject: ACO-REACH Scam at PeaceHealth, Washington State

On May 27, 2022, I received a “Notification Letter: No Action Needed” letter from PeaceHealth informing me of my status within their DCE-REACH program Cascadia Community Care Alliance. This was when I first learned that my PERSONAL medical file had been shared with a for-profit entity without my knowledge or consent. Yes, I had been involuntarily and surreptitiously enrolled in this dangerous, privatized Medicare scam, along with 2.1 Million Original Medicare recipients. Recently, the federal government has indicated that there will be no new corporate ACO-REACH program start-ups. This announcement is certainly welcome news; yet as one of the trapped 2.1 million Original Medicare recipients, I must respectfully insist that my medical file be returned to the Original Medicare management system at PeaceHealth and removed from your third-party for-profit ACO-REACH entity.

Sadly, my doctor’s previous patient-centered approach at PeaceHealth is being directed by a for-profit entity regarding what Medicare services I will—and will not—receive in future. This is a complete betrayal of my trust. Simply put, my doctor is For-Profit, not For-Me, as (I assume) a condition of his employment. I wish to be notified in writing that PeaceHealth has removed my file from this for-profit REACH scam and returned to its Original Medicare recipient folder.

Please consider this letter to PeaceHealth as my “Notification Letter: Action Needed.”

Respectfully,


Lynda Hanscome, Ed.D.
Educator (Retired)
cc:
President Joe Biden
President of the United States

Congressman Rick Larsen
Washington 2nd District

Senator Patty Murray
Washington State

Senator Maria Cantwell
Washington State

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Dick Conoboy

Mar 14, 2023

Lynda,

Thank you for informing us of your well-put letter.  I encourage others to follow suit.  It would be nice if Dr. Gober finds here new desk covered with similar letters. 

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M. Lynda Hanscome

Mar 14, 2023

Thank you, Dick.  I sent the letter via postal service and the copies to the others as well.  We’ll see what happens; the entire mess makes me furious.

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Randy Petty

Mar 21, 2023

Is this the program you’re referring to?
The link should take you to a filtered view of the data where location contains “WA” and one of the name columns contains “Family.”



ACO Organizations Filtered

 

 

 

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M. Lynda Hanscome

Mar 21, 2023

Randy, I will look at the link.  But in the meantime, PH’s ACO-REACH is called Cascadia Community Care Alliance.  They did not grab all patient files when they set this scam up.  They only ‘aligned’ the patients from whom they could make the most money from via Medicare.  My file was stolen; my husband’s was not.  I  am well; he is not as well.  The process of up-coding and ultimately reducing and delaying treatments for any condition/illness is part of this scam.  The healthier the patient, the more they scam.  They aim not to get caught (audited) by the Federal government.  Cascadia Community Care Alliance sniffs out every opportunity to make money—that is their ONLY goal.  Lynda Hanscome

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