Comment by aaavl2821

I think many health systems are using the ACA as a pretext for establishing further monopoly power. Basically the line for the public is "we need all providers in one system so we have all the data and so we can refer patients to the right site of care"

In reality they are bringing all providers under their umbrella to control patients i.e. Market share, and to drive patients to the site of care that is most profitable to them under the constraints of minimizing malpractice risk and quality fines. ACOs are in many cases just a way to increase patient volume at a discount to payers and have nothing to do with risk sharing

Hospitals are an incredibly political powerful entity. The AHA (hospital industry lobbying group) spends about as much as Phrma (pharma lobbying group), but hospitals have massive grassroots political support bc they are huge employers whereas the public hates pharma

/endrant