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First Reactions to ACO Proposed Rule

March 31, 2011
by Mark Hagland
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Associations respond with caution, some concerns

Within hours of the release of its proposed rule on the development of accountable care organizations (ACOs) by the federal Centers for Medicare and Medicaid Services (CMS), provider associations were reacting with caution to some of the details of the rule, while working to analyze its provisions.

Some were more positive than others in their first statements and comments.

At the Englewood, Colo.-based Medical Group Management Association (MGMA), president and CEO William F. Jessee, M.D., released a statement that said, “The formation of ACOs has the potential to greatly improve the coordination of care received by Medicare beneficiaries, and offers the promise of safer, more efficient and effective care.” But, Jessee immediately added, “The complexity of the program as proposed is significant. With multiple agencies proposing rules on the same topic, physician practices need to thoroughly examine how participation in ACOs may affect their practice operations. MGMA and our members will develop specific feedback to CMS and the other agencies to ensure that any overly restrictive or administratively burdensome requirements are addressed so this well-intended concept can become a practical reality."

And Linda Fishman, senior vice president for policy at the Washington, D.C.-based American Hospital Association, added her concern from the hospital industry perspective, when in a statement, she said, “This is an historic effort among government agencies to achieve the goal of better coordinated care… However, it does not go nearly far enough to eliminate the barriers to clinical integration among caregivers.”

Representing healthcare IT executives, Sharon Canner, senior director of advocacy for the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), said, “The industry is striving to deliver better care for less money. And I believe the core components of ACOs—efficiency through collaboration, cost reduction through networks—are largely dependent on the tools of health IT.” She added, “Having the ACO rules at this time helps to focus policy discussion on the all-important payment component of healthcare.”

Sharon Canner

Meanwhile, Blair Childs, senior vice president of public affairs at the Charlotte-based Premier healthcare alliance, said in a statement, “The Premier healthcare alliance supports CMS in its efforts to develop people-centered, sensible regulations for ACOs. This new model of care delivery represents one of our best hopes for overcoming fragmentation in care delivery. In forming ACOs, we believe that we will achieve greater clinical integration and collaboration among doctors, hospitals and other care providers, and foster alignment of accountable care principles across public and private payers. The end result will be better, safer and more convenient care delivered at a lower cost for the benefit of healthcare consumers nationwide.”

Blair Childs

Childs’ statement went on to say, “Premier believes it is critical that government regulations do everything possible to remove impediments that could derail ACO development, as well as select ACOs and structure the program to maximize the potential for success. With this in mind, Premier offers reactions to several key provisions in the rule.”