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Reactions to ACO Final Rule


Health care industry organizations have mostly come out in favor of the new changes to the Medicare Accountable Care Organizations, but not everyone is sold.

After the Department of Health and Human Services released its final rules regarding Medicare Accountable Care Organizations, health care industry organizations have come out to either applaud or denounce the changes.

The new rule changes make it easier for physicians “to participate in this important effort to improve patient care,” according to the American College of Physicians. The organization is also happy that many of the changes consisted with its own submitted comments, such as less burdensome reporting requirements and EHRs being encouraged but not mandated.

The final rule for the Medicare Shared Savings Program excluded indirect medical education payments when determining shared savings. The Association of American Medical College applauded the effort to give medical schools and teaching hospitals a better chance to participate in ACOs.

America’s Health Insurance Plans released a statement from President and Chief Executive Officer Karen Ignagni that supported the new rule changes because they will help “put the nation’s health care system on a sustainable path.”

“The ACO program takes important steps towards achieving greater accountability and better quality care for patients across our health care system,” she said in the statement. “Through this program, providers are incentivized to make critical investments in infrastructure and to redesign their care processes to meet new quality and cost targets.”

The American Hospital Association was pleased with the changes, especially since they addressed concerns AHA had brought up: flexibility in assignment of beneficiaries, the financial model and quality framework.

“We believe today’s menu of ACO options allows America’s hospitals to create new models of Accountable Care Organizations on which the transformation of health care delivery is so dependent,” Rich Umbdenstock, president and chief executive officer, said in a statement.

Of course, not all are happy with the changes. AdvaMed has come out with a statement that it is “concerned” and “disappointed.” The organization’s executive vice president, Ann-Marie Lynch, said that the rule failed to include provisions to support medical progress and didn’t address key issues.

“This rule is a missed opportunity to ensure that the sweeping changes in payment policy established by the Affordable Care Act will support medical progress and assure that patients can receive the care most appropriate for their needs,” Lynch said.

ACHIP isn’t entirely content with the rules either. Ignagni also said that instead of reimbursing for volume of services provided, the ACO program should “reimburse doctors and hospitals based on improving quality, safety and efficiency of patient care.”

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