Senators Urge White House to Withdraw ACO Proposal

The Centers for Medicare & Medicaid Services should withdraw its proposed rules governing accountable care organizations in part because of expensive start-up costs required, seven Republican lawmakers said in a letter to the Obama Administration Tuesday.

"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," says the letter, which is signed by Tom Coburn, MD, (R –OK); Mike Crapo (R-ID); John Cornyn (R-TX); Jon Kyl (R-AZ); Mike Enzi (R-WY); Pat Roberts (R-KS); and Richard Burr (R-NC). 

It's not just high costs, the Senators said. "Incentives and accountability are misaligned. Detailed requirements are complex and return on investment is uncertain."

"Innovative integrated health providers such as the Billings Clinic, Intermountain Healthcare, the Cleveland Clinic, the Mayo Clinic, Sutter Health, Marshfield Clinic have expressed serious concerns with the details of the proposed rule." Even all 10 members of the Physician Group Practice CMS demonstration project have expressed "serious reservations," the senators wrote.

"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+ page proposed rule as a model for the ACO regulation."

The May 24 letter was addressed to U.S. Department of Health and Human Service Secretary Kathleen Sebelius and CMS Administrator Donald Berwick, MD. HHS did not immediately issue a response.