AHA of­fers rec­om­men­da­tions on CMS ACO guide­lines

Modern Healthcare - - Late News -

The Amer­i­can Hos­pi­tal As­so­ci­a­tion sub­mit­ted an 11-page let­ter to the CMS on guide­lines the agency is de­vel­op­ing to guide the na­tional im­ple­men­ta­tion of ac­count­able care or­ga­ni­za­tions. The let­ter in­cluded a full-page graphic de­pict­ing eight laws and reg­u­la­tions that the AHA says are de­signed to stop the kinds of co­op­er­a­tion that the fed­eral govern­ment now seeks to en­cour­age. For ex­am­ple, the as­so­ci­a­tion said, an­titrust laws and the anti-kick­back statute can be used to pro­hibit hos­pi­tals from form­ing closer re­la­tion­ships and fi­nan­cial in­cen­tives in­volv­ing physi­cians, even though the ACO places heavy em­pha­sis on clin­i­cal in­te­gra­tion as a way to achieve cost ef­fi­cien­cies. The AHA urged the CMS to elim­i­nate le­gal bar­ri­ers to such in­te­gra­tion. The Amer­i­can Med­i­cal As­so­ci­a­tion, in its own com­ment let­ter, sim­i­larly called for an ex­plicit ex­emp­tion, or safe har­bor, from an­titrust laws for ACOs, say­ing the re­lief would al­low in­de­pen­dent physi­cians to re­main in­de­pen­dent within an ACO. The AMA also 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.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.