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“CMS’s effort, launched by Obamacare, to use the leverage of Medicare reimbursement to impose and control a favored model of health care delivery is bound to fail, but only after increasing the angst of providers and patients and dissipating large amounts of resources—money, time, and brainpower. It blocks the development of other ideas for reforming health care delivery. However, changes in the proposed regulations to fix the anomalies and problems discussed above, and numerous other provisions like them not discussed here, would not be sufficient to rescue the scheme. The Shared Savings Program and its ACOs are fatally flawed by the overweening assumptions embedded in the PPACA itself.”

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