AMGA Raises Red Flag on 'Burdensome' ACO Rules
Fisher told HealthLeaders Media that he is disappointed that CMS didn't use the lessons learned from the group practice demonstration project. "These requirements to become an ACO are much more stringent that what the group practice folks had to go through, and at the end of their five-year period they were able to demonstrate that they improved outcomes and saved money," Fisher said. "Why would you want to raise the bar even higher for the next level of participants in this experiment. The 2% minimum savings was the maximum for the group practice demo folks. Now we have raised it to 3.9%. They did have retrospective attribution and that was a real problem for them and they complained. We were hoping CMS would fix it, but they didn't."
Fisher said AMGA hopes to work with CMS to revise the rules, but AMGA is also prepared to go to Congress to ask for help if CMS is unwilling or unable to amend the rules. "This is the real opportunity in the Affordable Care Act to reform the healthcare delivery in this country. We want to see it work," he said.
John Commins is a senior editor with HealthLeaders Media.
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