Medical Tuesday Blog

Time to put real ‘accountability’ in Accountable Care Organizations

Sep 14

Written by: Del Meyer
09/14/2018 12:21 PM 

One Week At CMS: Steps Toward Transformative Changes

Grace-Marie Turner Contributor https://galen.org/

https://www.forbes.com/sites/gracemarieturner/2018/08/11/one-week-at-cms-steps-toward-transformative-changes/#5206436115ac

The Centers for Medicaid & Medicare Services is continuing the drumbeat of modernizing the two gargantuan programs it runs to generate more accountability, greater transparency, and provide better value for both patients and taxpayers.

Administrator Seema Verma announced on Thursday a new proposed rule that would bring more accountability into “Accountable” Care Organizations (ACOs), created under the Affordable Care Act to encourage hospitals, physician practices, and other providers to replicate the best practices of organizations like the Cleveland Clinic and Geisinger Health in delivering better quality health care at lower prices.

ACOs agree to take responsibility for the total cost and quality of care for their patients and, in return, receive a portion of the savings they achieve. CMS provides them with some waivers from Medicare rules to allow them to innovate.

But as Verma explains in a Health Affairs article, “Pathways To Success: A New Start For Medicare’s Accountable Care Organizations,” the results of the government-directed versions of ACOs have been disappointing.

Despite its intent, the program has shown increases in net spending for CMS and taxpayers. Verma says that, “After six years of experience, the time has come to put real ‘accountability’ in Accountable Care Organizations.  Medicare cannot afford to support programs with weak incentives that do not deliver value.”

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Why do we even discuss improved quality of care? We already have the highest QOC of the 189 nations on earth. Let’s not the non-progressives denigrate us.

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