RWJF recommends adjustments to proposed ACO rule

Accountable care should have, at a minimum, a focus on patients and consumers, timely and widely available data, collaborative teams and a reformed payment scheme, and should promote population health and monitor for racial, ethnic and language-related health and healthcare disparities, stated the Robert Wood Johnson Foundation (RWJF).

RWJF President and CEO Risa Lavizzo-Mourey, MBA, last week sent a letter to Don Berwick, MD, administrator for the Centers for Medicare & Medicaid Services (CMS), that included the group's comments on CMS' proposed rule for accountable care organizations (ACOs).

The Princeton, N.J.-based foundation recommended some adjustments to the proposed rule:

• Utilize existing regional alliances, including RWJF’s Aligning Forces for Quality initiative. These initiatives have been able to make that progress by working with and through a regional alliance of key healthcare employers, physicians, nurses, consumers, hospitals, health plans and business leaders—"those who give, get and pay for care,” the letter stated.

• Identify and implement efforts to align and partner with private sector payers, in building ACOs.
• Leverage beneficiary choice among patients by educating them about ACO quality and cost.
• Provide timely, transparent performance data and information that goes to the individual health professional level.
• Expand ACO participants by allowing federally qualified health centers and rural health centers to be ACOs, and for care from independent nurse practitioners at nurse-led centers to be part of the Shared Savings Program.
• Close racial and ethnic disparities by requiring the stratification and public reporting of quality measures by patient race, ethnicity and primary language.
• Address how ACOs enhance population health and broad health determinants by requiring more specific population health assessment metrics and the utilization of local population health status data; working with patients, consumers, caregivers and other organizations in addressing multiple determinants of health; and devoting a part of the shared savings to local population health improvement activities.
• Create rules for participation that allow for adaptation over time to build trust and confidence in this new, and voluntary, approach among health professionals.

“We appreciate your leadership of this critically important national endeavor to foster greater accountability in health and healthcare across the nation,” the letter concluded.