Scripps Health CEO Chris Van Gorder told HealthLeaders that the new proposals are unlikely to change his stance, which is to not apply or participate in the ACO demonstration concept.
"The downside is still too risky for a start-up and these elements are not well explained. Would not commit to anything until we saw all the revised regulations and see how these new elements fit with the other revisions. If this is the extent of the changes, the answer would be still no."
Nick Turkal, MD, president/CEO of 15-hospital Aurora Health Care, the largest private employer in Wisconsin, told HealthLeaders that the new offerings CMS unveiled on Tuesday do not address his fundamental concerns about the high risks and low rewards for ACOs under the proposed rules.
Turkal says Milwaukee-based Aurora had hoped to take part in the ACO program, but won't do so unless the proposed rules are significantly changed.
"The fundamental issue is if CMS has proposed a model which is not going to work," says Turkal. "After the June 6 public comment period, are they fundamentally going to change the model or is it going to be just some minor adjustments around the edges? The real answer is that without some fundamental change in CMS' current proposed model, there are not going to be many takers."
CMS intends to run these programs out of the new Center for Medicare & Medicaid Innovation, an entity created by the Affordable Care Act and which is said to be spending $10 billion in an effort to find new ways to pay for and deliver healthcare.