Medicare ACOs Move Closer to Commercial Model Under Final Rule
In a statement, Karen Ignagni, president of America's Health Insurance Plans, said that the program takes important steps towards achieving greater accountability and better quality care." She added, however, that the organization remains "concerned about the trend of provider consolidation that drives up medical prices and results in additional cost-shifting to families and employers with private coverage."
"The initial regulation," Ignagni said, "created an antitrust screening mechanism that would have protected consumers with a mandatory up-front antitrust review and exclusion from the program for those ACOs facing a legal challenge. Doing away with the mandatory review process raises concerns that provider market power may not be scrutinized sufficiently, potentially increasing health care costs for consumers and employers.
AHIP , which filed in June a 20-page comment letter on the proposed ACO regulations, declined to comment on how the final regulations address the specific concerns expressed in that letter. "We are still going through the regulations and will have additional comments in the future," explained Robert Zirkelbach, press secretary for AHIP.
While the final regulations hold promise for health plans, Siler said that as stakeholders have a chance to completely review the 626-pages of regulations they may discover that "CMS has made this an easier pill to swallow, but it's still difficult to digest."
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
- Antibiotic Overuse a 'Huge Threat' to Patient Safety, Says CDC
- 3 Traits Personality Assessments Can't Reveal
- Consumerism Drives Healthcare Branding, Rebranding Efforts
- CHS Hacked, 4.5M Patient Records Compromised
- PA Ranks See 'Phenomenal Growth,' Lack of Diversity
- Business Roundup: M&A Activity Down Slightly in First Half of 2014
- CFO Exchange: Healthcare Leaders Share 5 Innovative Ideas
- CFO Exchange: Smartphones Poised to Disrupt Healthcare, Says Topol
- Large Employers Trimming Healthcare Spending
- 3 Things the Ice Bucket Challenge Can Teach Hospital Marketers