The government's ACO bus has finally arrived. Its 429 pages of proposed guidelines having spilled out, all of healthcare is now scampering to read the lines and between them.
Under the accountable care organization model, there are many participants. But whether there will be enough room for physicians to participate to their liking, or whether ACO is a new form of HMO are a couple of the many questions in the great debate surrounding the release of the proposed rules.
Overall, there are mixed reviews on the Centers for Medicare & Medicaid Services proposed rule proposed ACO regulations released last week.
Donald Berwick, the CMS administrator, and Kathleen Sibelius, the head of the HHS, say the model could save millions of dollars in Medicare funds and improve care for Medicare patients, and that they shouldn't be equated with HMOs, not at all.
Along with the shadow of the HMOs – seriously, the critics whisper HMOs all the time, and sometimes mention "HMOs on steroids" – what's in store for physicians?
Roland Goertz, MD, MBA, FAAFP, president of the board of directors of the American Academy of Family Physicians, recalls being a VP of medical affairs at an integrated system years ago and recalls when managed care was moving "full steam ahead" in the 1980s and 1990s, and "some of the factors that drove it were similar to today."
HMOs are not ACOS, no way, he says, but healthcare needs to fix cost as a driving force in the care delivery model, with physicians in the mix.
Like most other physician groups, the American Academy of Family Physicians is studying the proposed CMS regulations regarding ACOs. While there are some areas of concern that have been addressed, others have not yet been determined, Goertz says.