7 U.S. Senators call for rewrite of Medicare ACO rule

Seven U.S. senators wrote a letter this week to Obama Administration officials stating that, given the proposed regulations, the Medicare Shared Savings Program “will fail to accomplish it’s purpose” (Source: “7 Senators say ACO model doomed to failure,” Government Health IT, May 25, 2011).

In the letter to Health and Human Services Secretary Kathleen Sebelius and CMS Administrator Don Berwick, the Republican senators –- Tom Coburn (Okla.), Jon Kyl (Ariz.), Mike Crapo (Idaho), Mike Enzi (Wyo.), John Cornyn (Texas), Pat Roberts (Kansas) and Richard Burr (N.C.) -– cited reports that all 10 members of the Physician Group Practice (PGP) CMS demonstration project (including the Cleveland Clinic) have expressed reservations about participating in the MSSP under the proposed rule.

“The concerns over the ACO regulation from some of our nation’s most knowledgeable and innovative health care providers are clear,” the letter stated. “Incentives and accountability are misaligned. Detailed requirements are complex and return on investment is uncertain.”

The letter also alluded to a study released last week by the American Hospital Association that concluded that start-up costs are likely to be significantly higher than CMS estimates (“AHA says start-up costs for ACOs higher than expected,” Healthcare Finance News, May 16, 2011).

Last week HPIO released a policy brief  titled “Understanding the Medicare ACO and Its Potential Impact on Ohio and the Nation: Considerations of CMS Draft Rules” (pdf, 24 pages).