Seven GOP Senate Finance Committee members slam ACO regs

Seven Republican members of the U.S. Senate Finance Committee have sent a letter to the Department of Health and Human Services Secretary Kathleen Sebelius and the Centers for Medicare and Medicaid Services (CMS) Administrator Donald Berwick, voicing their concerns about the regulation of ACOs.

The seven committee members, including Richard Burr (R-N.C.), Tom Coburn, MD (R-Okla.), John Cornyn (R-Texas), Mike Crapo (R-Idaho), Mike Enzi (R-Wyo.), Jon Kyl (R-Ariz.) and Pat Roberts (R-Kan.), stated they appreciate the time and effort invested in developing the draft ACO regulation. “However, we have been struck by the increasingly diverse chorus of concerns many of our nation’s leading healthcare institutions have raised in recent days about the proposed ACO regulation,” they wrote, adding that innovative integrated health providers, including the Billings Clinic (Mont.), Intermountain Healthcare (Utah) and the Cleveland Clinic (Ohio) have expressed serious concerns with the details of the proposed rule.

All 10 members of the Physician Group Practice (PGP) CMS demonstration project have expressed reservations about the regulation’s current construction, the authors added.  “It is troubling that their participation is doubtful, since these PGP members and experience are cited more than 75 times in your Agency’s 400-plus page proposed rule as a model for the ACO regulation.”

Citing feedback from providers, who said incentives and accountability are misaligned, the committee members branded the proposed regulations as a failure that will not accomplish the intended purposes. “Therefore, we respectfully ask that you withdraw this proposed rule and re-engage experienced stakeholders to craft a new rule that fulfills the promise of ACOs,” they wrote.

More ACO-like coordination and collaboration among providers and beneficiaries is a worthwhile goal and an ACO model that can increase provider coordination and patient accountability would be a step in the right direction compared with today’s fragmented delivery system. "However, it is increasingly clear this proposed rule misses the target,” the senators wrote.

“We look forward to the department redesigning a regulation that will truly help accomplish our shared goals for patients, providers and taxpayers alike: better care at lower costs,” the committee members concluded. “In the weeks ahead, we look forward to working with you and other administration leaders on this matter.”

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