A painful hip and much limitation of my activities led to a consultation with an orthopedic surgeon who said I was not a viable candidate because the pain and disability were insufficient to qualify. My own judgment of medical need was not as decisive as some external criteria. He urged me to adjust better to my advanced age by further limiting my activity.

This experience may become all too common under the AOC REACH program. The Center for Medicare and Medicaid Services (CMS) Innovation Center aims to place seniors into AOC REACH without their knowledge or consent. The program will financially reward physicians who can “…. reduce program expenditures…while preserving or enhancing care….” Physicians for a National Health Program has extracted and published the details of the program and raised an alarm about the lack of safeguards against exploitation. Medical outcomes are often unclear, and the above consultation could be coded as a success since I left with just a mild protest. As Senator Warren and Representative Jayapal have pointed out, some of the same business investors who cheated the Medicare Advantage program are enrolled in REACH. They have suggested that the program be scrapped. Meanwhile, the program has been running since January 1, 2023, and I do not know if the surgeon was telling his honest opinion or merely adding to his good statistics.