Kester Freeman, former CEO, Palmetto Health, wrote in a blog, after the HHS released the proposed ACO rules, "While steps are being taken to avoid antitrust issues, I feel all of these details need to be resolved ahead of time so that hospitals and physician groups can feel confident they can collaborate freely," he says. "The antitrust regulations need to be in place before January 2012 so there is clarity for all involved."
Indeed, the anti-trust issues and complex, making his organization tentative, at best, about the steps ahead, says Goertz.
"The previous model of healthcare arrangement, unfortunately, did not foster organizations of physicians getting together in the same way other organizations in healthcare would get together because of anti-trust rules," Goertz says. "This is one of the rules we are looking at very closely. We are very careful not stepping over the line right now."
"We are in favor of not having in the future a solely fee-for-service payment; we are advocating a blended payment," says Goertz. "We believe ACOs will have to move in that direction. But we have concerns that if we put specifics of a blended model, we would be accused of antitrust activities, in urging all our members to contract this way or that way."
"There are a lot of restrictions we need to sort out to see if there is some leeway, without harming free trade – and at the same time (giving) family physicians their best options."
"I am," he says, "cautious."