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Miami docs are employing cost cutting model spawned by Affordable Care Act

Patient Robert JAfter suffering two heart attacks within one month in 1997, Robert Rivera sees a cardiologist regularly, and a nephrologist for an unrelated kidney disorder. But it’s his primary care physician, an internist, whom Rivera trusts most.

“I wouldn’t change him for anything in this world,’’ says Rivera, 71, who lives in South Miami-Dade County and works in the financial industry. “He sees me every three to four months, and he’s been doing this for 16 years.’’

Rivera, a Medicare beneficiary, coordinates all of his medical care through his internist, who referred all the specialists, and he now receives the kind of comprehensive treatment that he never experienced before the two heart attacks, including regular preventive screenings, management of his blood pressure and cholesterol levels, and convenient access to his doctors.

In concept, the coordinated medical care that Rivera receives is nothing new, containing some of the familiar components of traditional health maintenance organizations, such as reducing unneeded medical procedures and careful selection of providers who will work for pre-negotiated rates.

But Rivera’s doctor belongs to a group that has applied to become an accountable care organization or ACO — a creation of the Affordable Care Act that policy makers say will improve the quality of medical care and lower costs by financially rewarding providers who can demonstrate that they keep their patients healthy at less expense. More here from Dan Chang

Photo: Prime Health partner Dr. Diego Saavedra, left, takes the pulse of his patient, Robert J. Rivera, right, during an office visit. Prime Health is a group of South Florida doctors who banded together to form an ACO or Accountable Care Organization, a creation of the Affordable Care Act which rewards physicians for lowering healthcare costs and improving quality. CARL JUSTE / MIAMI HERALD STAFF