AMGA pans proposed ACO regulations

Group-practice physicians rejected the highly anticipated accountable care organization rules proposed on March 31 and told regulators to try again.

The American Medical Group Association submitted formal comments Wednesday on the proposed ACO rules (PDF) that described them as “overly prescriptive, operationally burdensome” and “too difficult to achieve.”

“We're really talking about significant changes being needed; it's not just a matter of a tweak here and a tweak there,” Donald Fisher, president and CEO of AMGA, said in an interview.

The member-physicians' concerns with the proposed regulations centered on the risk-sharing requirements, use of retrospective patient attribution, quality measurement requirements and minimum savings requirements.

Without “significant” changes in the final rule expected later this year, the AMGA said, very few providers likely will enroll as ACOs, despite the expectation of healthcare experts that multispecialty medical groups would form the spine of a nationwide network of ACOs. Those expectations of low participation are based on the results of an AMGA member survey conducted shortly after the proposed rule's release that found 93% would not enroll as an ACO under the current regulatory framework.

The AMGA's board of directors already has expressed its members' concerns to regulators in a meeting with Jonathan Blum, deputy administrator and director of the CMS, and he appeared receptive to changes they asked for, Fisher said.

“We wanted them to know that they really did miss the mark,” Fisher said.