HCI3 Update from the Field: Pioneers in Name

Submitted by francois.debrantes@hci3.org on Friday, March 8, 2013 - 01:28

Newtown, CT – March 8, 2013

They call themselves the "Pioneers", but naming oneself such and being one is very different – When CMS was in process of issuing its final rule on what the "Pioneers" would be held accountable for, many of us expressed concern over giving these organizations too much of a pass. In fact, one of our recommendations was to hold the ACOs financially accountable for some of the quality measures in the first year, not simply in the second. The point we made, and reinforce today, is that this program should not be about the quantity of those who can demonstrate excellence. No one, not at CMMI, at HHS, in the White House, Congress or anywhere in the US should care whether there are 32, 22, 12 or 2 true Pioneers. What's important is that we identify the real ones and use them as a beacon for all others. So why am I bringing this up today? Because the roosters have turned to chickens, and if we let them turn their coats, it's unlikely we'll get any eggs to hatch. In a recent letter to Rick Gilfillan, the "Pioneers" have raised a sort of ultimatum. They claim that the year of reporting wasn't enough (nor all the years they had prior to participating in this effort in which they were supposedly performing awesome care), and that they need another year of reporting before CMS holds them accountable for their quality performance….or else!!!

What this means to you – This is more than a bad joke, and if CMMI relents, the folks in charge there should replace their phone ring tones with a cluck-clucking and paint their offices yellow. And then they should deeply apologize to the American people and resign from office. The quality measures that the ACOs are being held to are standard quality measures, and if these organizations can't meet the minimum thresholds, they should be penalized. Plain and simple. And if they want to drop out, let them walk the walk of shame and be exposed for what they are: Pretenders, and not Pioneers. Pioneers don't mind taking a hit and, in fact, they expect it and use that setback to motivate themselves, learn from the failure and move on. Coddling the Pretenders does a disservice to the real Pioneers and to all of our collective efforts to make the system more effective and efficient. Giving in to this seeming ultimatum will send a clear message to all engaged in CMMI pilots…when the going gets tough, turn into a chicken and your nest will be feathered. Here's hoping that Rick Gilfillan is really a chicken hawk, because we're the ones whose feathers will get plucked to feather those nests.


Francois de Brantes
Executive Director
Health Care Incentives Improvement Institute, Inc.
w: www.hci3.org