AMGA Raises Red Flag on 'Burdensome' ACO Rules

John Commins, for HealthLeaders Media , May 13, 2011

The American Medical Group Association warned this week that proposed rules governing accountable care organizations are "overly prescriptive" and "too burdensome," and will discourage physician participation.

In a letter to Centers for Medicare and Medicaid Services Administrator Donald Berwick, MD, AMGA President/CEO Donald W. Fisher warned that a survey of its members found that 93% would not enroll as an ACO under the proposed regulations.

According to the HealthLeaders Media Industry Survey 2011, more than half, (52%) of physicians surveyed said they expect to be part of an ACO within the next five years. That survey, however, was completed months before the proposed rules were released in April.

"Our membership's concerns were many and focused on issues such as the risk sharing requirement, static risk adjustment, retrospective attribution, quality measurement requirements, the Minimum Savings requirements and others," Fisher said in the letter. "Without substantial changes in the Final Rule, we fear that very few providers will enroll as ACOs and that CMS and the provider community will miss the best opportunity to inject value and accountability into the delivery system."

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1 comments on "AMGA Raises Red Flag on 'Burdensome' ACO Rules"

Daniel Connelly (5/13/2011 at 8:59 AM)
ACOs are an Obama supported initiative, first started as a concept in 2006. They are basically a rehash of the PPO with a few twists. The ACOs are promoted by Physicians for a National Health Program (PNHP) whose activist list in NJ is the unions. PNHP wants the bill HR676 passed to put everyone on medicare. Why would PNHP, the unions, and Obama liberals promote ACOs, when they really want medicare for everyone? ACOs are designed specifically to fail as an intermediate step to full government run socialized medicine. The following is the brief on how this would happen and I believe that it would happen quickly. 1. Hard working physicians are dazzled with the promises of the ACO. Collaborative, integrated accountable care will decrease overhead, improve care and decrease the work load of physicians. That's the bait. 2. Down play the transfer of "risk" from the insurance companies, the union plans, and the government to the ACO. That's the trap. 3. The ACO becomes the defacto insurance company with all attendant risks, no multimillion dollar reserve or the ability to print money. 4. The physician is torn being the patient advocate and the insurer delayer/denier of claims. Deny a claim (demand for service) and get sued. Be the patient advocate and don't deny claims, the ACO becomes insolvent, bankrupt, financially unviable. 5. The federal government steps in to save the failing ACOs and incorporates them into the national system, along with all the business assets 6. With most of the medical business assets,(people,equipment, offices and hospitals) under federal ownership, a private system will not be allowed to, or be able to reconstitute.




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