Premier has mixed feelings on final ACO rule
Multiple payment models with the accountable care organization (ACO) program is a big hit to Premier healthcare alliance, a hospital and healthcare stakeholder-owned performance improvement organization, which released a statement on the Centers for Medicare & Medicaid Services’ (CMS) final rule on ACO requirements.
The alliance of more than 2,500 U.S. hospitals and 77,000-plus other healthcare sites wrote, “As we have learned from members of the Premier collaboratives, different ACOs are at different points in their journey to deliver accountable care, with some prepared to accept shared savings, while others are able to accept risk.” It suggested including an option that does not involve downside risk and allowing first dollar savings once the minimum savings rate is achieved.
“These two changes to the model will provide an enhanced business case for organizations to enter the program,” the Charlotte, N.C.-headquartered organization stated in a letter dated Oct. 20.
Premier additionally praised the decision to waive its initial requirement that at least 50 percent of all primary care physicians in the ACO would be considered meaningful users of EHRs in order to participate in the program. The choice to phase in the number of quality measures in the shared savings program will give providers adequate time to demonstrate capacity to improve care and health of their ACO population, Premier added.
After front-loading the letter with positive comments, the organization moved stated that it believes that CMS' decision to limit its savings split with providers to 50 to 60 percent will limit participation in the program. In addition, Premier is troubled that CMS has chosen to move forward with an “unworkable plan to allow beneficiaries to participate in the ACO, but also opt out of sharing the data.”
“Without access to beneficiary data, ACOs will be hamstrung in efforts to target interventions that are essential to improve care quality, provide convenient choices and enhance overall compliance with recommended care,” the letter read. “CMS' rigidity regarding beneficiary data could have the unintended consequence of limiting necessary services that would enhance compliance with treatment plans, and compromise the ACO's ability to achieve the goals of better health, better healthcare and reduced expenses.”
In regards to claims access, Premier noted that while CMS’ commitment to provide monthly data files is a step in the right direction, the process to obtain that data may be too cumbersome and outdated.
Despite its differences, the Premier healthcare alliance concluded it supports CMS in its efforts to develop people-centered, sensible regulations for ACOs. “The end result will be better, safer and more convenient care delivered at a lower cost for the benefit of healthcare consumers nationwide.”
The alliance of more than 2,500 U.S. hospitals and 77,000-plus other healthcare sites wrote, “As we have learned from members of the Premier collaboratives, different ACOs are at different points in their journey to deliver accountable care, with some prepared to accept shared savings, while others are able to accept risk.” It suggested including an option that does not involve downside risk and allowing first dollar savings once the minimum savings rate is achieved.
“These two changes to the model will provide an enhanced business case for organizations to enter the program,” the Charlotte, N.C.-headquartered organization stated in a letter dated Oct. 20.
Premier additionally praised the decision to waive its initial requirement that at least 50 percent of all primary care physicians in the ACO would be considered meaningful users of EHRs in order to participate in the program. The choice to phase in the number of quality measures in the shared savings program will give providers adequate time to demonstrate capacity to improve care and health of their ACO population, Premier added.
After front-loading the letter with positive comments, the organization moved stated that it believes that CMS' decision to limit its savings split with providers to 50 to 60 percent will limit participation in the program. In addition, Premier is troubled that CMS has chosen to move forward with an “unworkable plan to allow beneficiaries to participate in the ACO, but also opt out of sharing the data.”
“Without access to beneficiary data, ACOs will be hamstrung in efforts to target interventions that are essential to improve care quality, provide convenient choices and enhance overall compliance with recommended care,” the letter read. “CMS' rigidity regarding beneficiary data could have the unintended consequence of limiting necessary services that would enhance compliance with treatment plans, and compromise the ACO's ability to achieve the goals of better health, better healthcare and reduced expenses.”
In regards to claims access, Premier noted that while CMS’ commitment to provide monthly data files is a step in the right direction, the process to obtain that data may be too cumbersome and outdated.
Despite its differences, the Premier healthcare alliance concluded it supports CMS in its efforts to develop people-centered, sensible regulations for ACOs. “The end result will be better, safer and more convenient care delivered at a lower cost for the benefit of healthcare consumers nationwide.”