Provider groups support ACO concept, oppose implementation regulations

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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.”
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