Health Center Regulatory Issues, Uncategorized

ACO Rule Draws Criticism

By: Susan Sumrell

With the deadline for comments on the proposed rule on the Medicare Shared Savings Program and Accountable Care Organizations fast approaching, more and more critics are voicing their opinions on the CMS proposal.

CMS has heard critiques from across the health care spectrum, but a recent letter signed by all 10 members of CMS’ Physician Group Practice demonstration has caught a lot of attention. CMS relies heavily on the experience of the PGP demo as a base for the ACO model and the letter indicated that while the group is supportive of the concept of ACOs, they have “serious reservations” about the proposed rules, and therefore would be unlikely to join ACOs. This letter spurred another letter to CMS, this time from several Senate Finance Committee Republicans, citing the PGP demo letter and calling for the withdrawal of the proposed rule. “The concerns over the ACO regulation from some of our nation’s most knowledgeable and innovative health care providers are clear. Incentives and accountability are misaligned. Detailed requirements are complex and return on investment is uncertain,” the Senators state, continuing “[t]herefore we respectfully ask that you withdraw this proposed rule and re-engage experienced stakeholders to craft a new rule that fulfills the promise of ACOs.”

Since the release of the rule, CMS Administrator Don Berwick has encouraged organizations and providers to review the proposed rule and provide comment and Secretary Sebelius has said that these comments will be taken “very seriously”. CMS has also released three new initiatives from the Innovation Center on ACOs: Pioneer ACOs Model, Advanced Payment ACO Initiative , and ACO Accelerated Development Learning Sessions, all which provide unique opportunities outside of the proposed rules.

Comments are due June 6, 2011 and can be submitted at www.regulations.gov. For more on NACHC’s response to the proposed rule, click here.