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CMS Proposals for Accountable Care Organizations Are Described As Unworkable By Healthcare Organizations

May 12, 2011 | No Comments
Posted by Frank Ciesla

Today’s Associated Press article contains comments from the medical community that the Obama administration’s proposals for Accountable Care Organizations (ACOs) are unworkable.  The American Medical Group Association, which represents entities such as the Mayo Clinic, the Geisinger Health System, the Cleveland Clinic, and Intermountain Health Care (among others) wrote to CMS this week and indicated that more than 90 percent of its membership would not participate in the Medicare Shared Savings program because the draft ACO regulations are too onerous.  A link to the American Medical Group Association’s letter can be found here.

For PPACA to accomplish its cost containment objectives, a significant reorientation of the delivery of healthcare is essential.  The accountable care organization proposal was an attempt to accomplish this purpose, but as can be seen in the Associated Press article, the complexity of the proposed ACO regulations may thwart that purpose.  Without significant, meaningful participation by the healthcare provider community, ACOs are unlikely to achieve their shared savings objectives.  If CMS is forced to undertake a substantial and substantive re-draft of the proposed ACO regulations in response to industry comments, this will set the process back, from a time point of view, and will require a reengineering and reconsideration of how to accomplish the objectives of the Medicare Shared Savings program.

If additional legislation is required, that may change the entire ballgame, since that legislation will require cooperation between the Republican controlled House and the Democratic controlled Senate.

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