Medicare's ACO Final Rule Responds To Provider Concerns, But Leaves Device Industry Dissatisfied

Article preview from "The Gray Sheet"- October 24, 2011

Although CMS' newly finalized rule on accountable care organizations has allayed health care providers' fears of a program too burdensome to bother with, medical device manufacturers remain worried that ACOs will curb patient access to their products.

Medicare's ACO Final Rule Responds To Provider Concerns, But Leaves Device Industry Dissatisfied

Article preview from "The Gray Sheet"- October 24, 2011

Although CMS' newly finalized rule on accountable care organizations has allayed health care providers' fears of a program too burdensome to bother with, medical device manufacturers remain worried that ACOs will curb patient access to their products.

Released Oct. 20, the final regulation on the Medicare shared savings program differs from the proposed rule in several ways. For example, the rule now includes a reduced-risk option for providers, better financial incentives for ACO participants and a more phased-in approach for quality measures.

It also eliminates mandatory preliminary antitrust reviews for ACOs with significant market concentration, and replaces retrospective assignment of Medicare beneficiaries to an ACO program with prospective assignment.

"The final rules have created a stronger ACO program than was contemplated in the preliminary rules," CMS Administrator Donald Berwick told reporters Oct. 20.

Accountable care organizations are aimed at getting primary care physicians, specialists and other health care providers to work together more in caring for patients. The hope is that better coordination will improve the quality of care patients receive while also lowering costs by, for example, reducing unnecessary services such as duplicative diagnostic tests.

Continued...

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