The Drum Beats On

Kaiser Health News has a guest post from Michael Millenson excoriating the Proposed Rules, reinterating the well-published point that CMS may have just killed the concept of an ACO before it even got to the starting line.

We believe that ACOs as a theoretical model still have the potential to reduce cost, improve quality, and improve care, if perhaps only as a part of a multi-front reform initiative.  But without making significant changes, as Mr. Millenson notes so colorfully, CMS may find the list of ACO applicants embarrassingly and disappointingly short.

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Morning Links – Thinktank Edition

The Heritage Foundation, a leading DC conservative thinktank, thinks ACOs are nonstarters and are destined to fail to achieve their longterm goals of better care, lower cost, and higher quality.

Authors at Health Affairs, on the other hand, consider ACOs to be integral pieces of largescale payment and delivery reform, though perhaps not the silver bullet that CMS hoped.

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Former HHS Deputy Secretary Not Buying Into ACOs

Tevi Troy, the former Deputy Secretary for the Dept. of Health and Human Services, ripped into ACOs recently, calling them “HMOs on steriods.”  Do you agree?

Read the report here.

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CalPERS ACO Pilot Reports Millions in Expected Savings

An ACO pilot involving the California Public Employees’ Retirement System, Blue Shield of California, Catholic Healthcare hospitals, and Hill Physicians Medical Group is expecting upwards of $15m in expected savings, a representative of CalPERS reported.  In addition, the pilot program, which began its two year operation in January 2010, says its collaboration and coordiation of care helped significantly reduce hospital readmissions, inpatient stays, and length of inpatient visits for its 41,000 patients.

So this very well may be a boon for patient care as predicted, but is it worth the investment for providers?  No word on whether the potential savings rate for the pilot represents a return on the investment of the participants, though perhaps this positive news will breathe some life into the market’s outlook on CMS’s Proposed Rule and the potential for ACOs to accomplish the goals of better care at lower cost while still representing real financial incentives for providers to make the necessary investments.

Read more here.

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ACOs for AMCs?

Health Leaders Media ran an article last week on the provisions in PPACA authorizing healthcare innovation zones and potential rulemaking on pilot programs designed for Academic Medical Centers (AMCs) to participate in shared savings and other healthcare reform models.  AMCs should contiue to analyze their role in these cutting-edge reform models, as they have the manpower and the regulatory latitude to participate effectively and achieve results in quality and coordination of care. 

Full text here.

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Morning Links

MedeAnalytics discusses the overlap in quality measures between the ACO Proposed Rules and other CMS’s quaity reporting initiatives.

The Regional Care Collaborative Organization out of Colorado Springs promotes itself as an effective ACO model, launching a pilot project aimed at bending the curve for the state’s Medicaid expenditures.

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Early Criticism of ACO Proposed Rule

The ink is barely dry on CMS’s Proposed Rule for ACOs and there has already been a maelstrom of criticism.  HealthAffairs has an interesting post discussing some of the stickier issues.

The Proposed Rule makes exceedingly clear that CMS is asking – almost begging – for public input on these proposals.  Providers and health industry professionals should take these next 60 days to review the Rule with their attorneys and craft incisive comments to shape the Final Regulations.

ACOs are here to stay, folks, but their governing regulations are as soft as wet clay.  Providers must take advantage of this brief opportunity to help mold their final shape.

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