Medicare’s Final Rule for Accountable Care Organizations (ACO) Draws Fire from Healthcare Provider Groups

Prominent national health associations publish tough criticisms of the new final ACO rule

Pathologists and clinical laboratory managers have a ringside seat as the fight to introduce Accountable Care Organizations (ACO) gets underway. On one side is the federal government, represented by the Department of Health and Human Services (HHS). On the other side are a number of the nation’s most important healthcare organizations.

It is a fight that is heating up. The latest round came just weeks ago, when, on Tuesday, May 17, 2011, HHS unveiled its plan to accelerate the creation of Accountable Care Organizations (ACO) in this country, including publishing the final rule. It took just days for criticism from major healthcare organizations to fill the new reports.

For its part, HHS believes the new ACO model will save Medicare as much as $430 million over three years. However, many healthcare organizations publicly state that this ACO model contains more risks than rewards. They believe it places an unmanageable reporting burden on the hospitals and physicians that participate in the ACO.

Healthcare Organizations Criticize HHS’ new ACO Model Final Rule

Take the American Medical Group Association (AMGA), for example. Executives representing this influential association expressed their membership’s concern about the ACO proposal. In a letter to Donald Berwick, M.D., Administrator for the Centers for Medicare and Medicaid Services (CMS), the AMGA officials wrote that “In an AMGA survey of its membership, 93% of respondents stated that they would not participate in the ACO program unless the requirements in the final rule reflect major modifications to the proposals.”