Progressive group issues accountable care recs

A left-leaning public policy group issued new recommendations Monday morning on how to structure accountable care organizations (ACOs), promoted by the new healthcare reform law, to deliver better quality at lower costs.

Under the reform law, an ACO is a group of physicians and hospitals collaborating to provide efficient and quality care for a certain group of patients.

The Center for American Progress (CAP) report said ACOs should follow three major principles:

• "On payment reform, we encourage the development of physician-led accountable care groups alongside hospital-led organizations. The Centers for Medicare and Medicaid Services can encourage these organizations by tying financial rewards to reduction of preventable inpatient and emergency care, as well as providing organizational and technical support to physician-led organizations.

• "On payment incentives, we suggest a payment system that first optionally and then as a requirement leads providers to share in the financial risks of overspending as well as in the savings from underspending, relative to spending targets.

• "On rights and responsibilities, we believe that consumers should be active partners in improving the quality of their care. That means consumers should decide whether to join an ACO, and if they do, they should be able to count on rules for consumer protection and creative ways to benefit financially from seeking quality care at lower costs."

To help ACOs reach full potential, CAP said, healthcare providers must gather the right data on what patients need and how to best deliver those services. The estimated $30 billion for health information technology in last year’s stimulus package will help ACOs better share information, the CAP report said. Further, payment incentives must change to reward better care instead of paying for more services.

The CAP echoed concerns voiced by the Medicare payment advisory body earlier this month that ACOs might receive the same public backlash experienced by managed care organizations in the 1990s. 

The Department of Health and Human Services is expected to issue regulations on ACOs early next year.