Providers request significant changes to ACOs prior to implementation

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Automatic 2% Medicare cuts begin
Automatic 2% Medicare cuts begin

As the comment period on the accountable care organizations proposed federal rule approaches its end, provider groups and pilot programs are asking for numerous changes, including reducing quality improvement measures.

Comments on ACOs are due to the Centers for Medicare & Medicaid Services by Monday. The American Hospital Association said Wednesday that CMS should fix the risk-versus-reward equation. In a 24-page letter, the AHA laid out several items it would like to be reconsidered. Among them are allowing for flexibility about starting in 2012; letting ACOs add participants more frequently; adopting a smaller number of quality improvement measures; and changing hospital readmission measures to be more specific to heart attack, heart failure and pneumonia.

In other ACO news, a new report says one five-year model did not save as much money as expected. In 2005, 10 health systems across the United States were enrolled in a pilot program to test whether they could slow Medicare spending by treating elderly patients more efficiently while offering high-quality care, according to The Washington Post. If they did, they were rewarded with financial bonuses. At the end of the program in 2010, only four systems slowed spending enough to earn bonuses. The basics of the program are similar to the government's ACO model, the Post reported.