Provider groups support ACO concept, oppose implementation regulations

With the comment period on accountable care organizations to the Centers for Medicare & Medicaid now over, stakeholders seem to be clear with one voice: While they agree with the concept of ACOs, they find the regulations too “burdensome.”

Provider groups, including the American Medical Association and the Premier healthcare alliance, sent CMS comment letters that were supportive of ACOs but critical of implementation plans, the Bureau of National Affairs reported. The comment period ended Monday.

Accountable care organizations provide incentives to healthcare organizations, including long-term care providers, to provide quality care for less money. But organizations must follow a series of rules to qualify, and Premier and the AMA wrote that “it's critical government regulations do everything possible to remove impediments that could derail ACO development, to select strong candidate ACOs, and to structure the program to maximize the potential for success.” Premier added, “in this regard, the rule requires major improvement to ensure broad participation in the program.”

Additionally, the Medicare Payment Advisory Committee (MedPAC), which advises Congress of matters related to CMS payment and policy, wrote in its remarks that “shifting from volume-driven to value-driven care will not be quick or easy, and it cannot be expected that a single set of regulations will be able to address all contingencies or difficulties that may arise,” according to BNA.

In its evaluation, MedPAC also recommends CMS give beneficiaries more control over which ACOs they are assigned to. As proposed, CMS assigns beneficiaries retrospectively to an ACO to help determine shared savings. But beneficiaries should know whether their provider is operating under an incentive structure, MedPac advises. Similarly, the AMA suggests that regulators should “move further down the continuum toward some hybrid approach between prospective assignment and retrospective attribution.”

More in News

Senate bill seeks to empower long-term care ombudsmen, strengthen eldercare workforce

Senate bill seeks to empower long-term care ombudsmen, ...

Senate lawmakers are seeking to strengthen and expand the long-term care ombudsman program and boost the eldercare workforce through a bill to reauthorize the Older Americans Act of 1965. The ...

CMS: Providers may need to reimburse beneficiaries due to inaccurate therapy denial ...

Therapy providers should review therapy cap denials for 2013 and refund any beneficiary payments for these services, according to a Medicare newsletter released Thursday.

Court upholds $5.75 million verdict against former nursing home officers, board members ...

A $5.75 million verdict will stand and there will be no new trial in the case against officers and board members of a former Pennsylvania nursing home, a federal judge recently ruled.