Leaked memo reveals Dem strategy for defending healthcare reg

The Obama administration is anticipating criticism that a new regulation released Thursday could force seniors to lose access to their doctor, according to internal talking points obtained by The Hill.

The memo outlines the administration's defense of a new care coordination regulation released Thursday. So-called Accountable Care Organizations got a boost in the healthcare reform law and aim to reward coordination between physicians and hospitals by giving them a slice of Medicare savings.

The memo instructs federal officials on what to say if asked whether seniors will be forced to join an ACO or change physicians.

"Patient and provider participation in an ACO is purely voluntary. Patients in an ACO maintain complete freedom of choice to select their Medicare providers," the memo says.

"Improving coordination and communication among physicians and other providers and suppliers will help improve the care Medicare beneficiaries receive."

The memo also addresses fears that physicians and hospitals will seek to boost their Medicare savings by skimping on care.

"ACOs that skimp on care will not qualify for bonuses," the memo says. "Under the proposed rules, to share in savings, ACOs would meet quality standards in five key areas. (...) The proposed rules also include strong protections to ensure patients do not have their care choices limited by an ACO."

In addition, it attempts to lay to rest privacy concerns raised by the sharing of patient data among an ACO's medical professionals.

"Beneficiaries' data will not be shared if they don't want it to be shared," the memo says. "Beneficiaries will be given information in writing about sharing personal health data the first time that they see an ACO provider. At that time, they will be offered the opportunity to opt out of having their Medicare claims data shared with the ACO."

The nine-page memo apparently wasn't completed before it was circulated internally.

To the question "Won’t some ACOs become a monopoly and drive up costs while limiting access to care?," the document answers: "Need CMS to insert answer."