Case Management

Mentor moment: Senators ask for a new ACO proposed rule

Case Management Weekly, June 1, 2011

Seven U.S. senators believe the Accountable Care Organization (ACO) proposed rule will not only cost more than estimated but will not accomplish the program’s goals. They want CMS to try again.

CMS published the ACO proposed rule in the April 7 issue of the Federal Register. The ACO program allows groups of providers to work together to manage and coordinate care for Medicare beneficiaries through an ACO, according to CMS. An ACO may receive payments for shared savings if it meets certain quality performance standards.

Senators Tom Coburn (R-OK), Jon Kyl (R-AZ), Mike Crapo (R-ID), Mike Enzi (R-WY), John Cornyn (R-TX), Pat Roberts (R-KS), and Richard Burr (R-NC) wrote a letter to CMS asking the agency to scrap the current proposed rule and write a new one. The Senators say they have heard concerns from several leading healthcare institutions that believe the proposed rule will fail to accomplish the ACO program’s purpose. The senators also cite an American Hospital Association report which says implementing the ACO program will cost 10 times more than the proposed rule estimates.

The senators acknowledge that the ACO concept is a worthwhile goal, stating “An ACO model that can increase provider coordination and patient accountability would be a step in the right direction.” However, they believe “this proposed rule misses the target.”

Read and comment on the ACO proposed rule.

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