AHA offers recommendations on CMS ACO guidelines
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.