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HCOs find risks & opportunities in quest for reduced costs & improved quality
Date:8/1/2012

for Health Policy Research and Ethics, George M. Mason University, Fairfax, VA, a contributor to the special report.

ACOs are groups of physicians, hospitals, and other health care providers that are willing to assume responsibility for the care of a clearly defined population of Medicare beneficiaries. If an ACO succeeds in improving care and reducing costs, they receive a share in the savings achieved for Medicare. The CMMS created two ACO programs, the Pioneer Model, with 32 registered organizations, and the Medicare Shared Savings Program (MSSP), with 27 registered organizations. The basic difference is that the Pioneer program has a greater degree of financial risk and reward. "Many highly regarded health systems developed concerns after initial enthusiasm about the MSSP ACO model as a mechanism for accelerating their efforts to reduce costs while improving health care quality," notes Dr. Ballard.

Robert G. Porter, JD, MBA, and Amanda P. Tosto, RN, MS, of St. Louis-based SSM Health Care, consider the lack of beneficiary engagement in the CMMS ACO models to be a serious design flaw in the program. "The rule provides for invisible enrollment, meaning each beneficiary is enrolled on the basis of their claims history without regard for their actual preferences. This type of enrollment isn't consistent with SSMSL's transition to a patient-centered model of care that is based on the development of a transparent partnership among health care professionals, patients, and their families to ensure that decisions respect the patient's wants, needs, and preferences," they say.

Baylor Health Care System would like to file for Medicare Shared Savings ACO designation, but cannot. The program requires patient attribution via the tax identification number of the physician. Many of Baylor's physicians practice in groups that include non-Baylor physicians, with the entire group sharing a single tax ID. Therefore, Baylor would become finan
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Contact: Rachael Zaleski
mcpmedia@elsevier.com
215-239-3658
Elsevier Health Sciences
Source:Eurekalert

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