Federal regulators said Tuesday that they've heard loudly and clearly the healthcare industry's strong concerns about proposed accountable care organization rules.
Regulators say they're tackling ACO concerns
In turn, five key drafters of the proposed regulations from the relevant federal agencies—the CMS, HHS, the HHS inspector general's office, the Federal Trade Commission and the Internal Revenue Service—said that they are closely reviewing feedback to the ACO proposals.
"We're currently, as you can imagine, eyeball-deep in reading those comments, and we are in the process of improving the proposed rule," HHS medical officer and senior adviser Dr. Terri Postma told an audience at the American Health Lawyers Association's annual meeting in Boston.
All five panel speakers noted that the final regulations are likely to look different from the initial proposals. They also used the occasion to defend some of the proposals' more controversial aspects.
For example, many observers have bemoaned the fact that the population of potential patients for whom efficiency and quality of care are supposed to improve under an ACO won't be defined until after the services are provided to them—the so-called retrospective assignment of beneficiaries.
However, Postma said the ACO program is not a capitated, population-based risk model but rather an extension of the existing fee-for-service delivery system, for which retrospective assignment will work better. Also, retrospective assignment will encourage providers to treat ACO and non-ACO Medicare beneficiaries with the same level of care, because providers won't know until the end of the relevant period which patients qualify to be in the ACO.
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