The American Medical Association called for an explicit exemption, or safe harbor, from antitrust laws for accountable care organizations, a payment model that could create closer financial ties between hospitals and independent doctors.
The professional association said in a
letter to CMS that a safe harbor and other legal waivers (PDF) would be “the best way to preserve opportunities for appropriate competition in healthcare and choice for patients” by allowing independent physicians to remain independent within an ACO.
Under the health reform law, Medicare may contract with accountable care organizations, or networks of providers that agree to quality and cost-control targets in exchange for a share of the savings.
The AMA said the CMS also should adopt various payment models to prevent doctors from absorbing upfront losses and provide payment for services not currently covered by Medicare. The AMA called for the CMS to adopt payment models other than a shared-savings bonus, such as partial capitation, virtual partial capitation, accountable medical home payments and condition-specific capitation.
To ease possible capital burdens for ACOs, the CMS could create loans similar to those offered by the Small Business Administration or offer grants, potentially in collaboration with the Health Information Technology Extension Center program, the AMA said. The CMS also should limit capital-intensive requirements, the letter said.
