AHA asks CMS to ease ACO regulations

In response to a request for comments from the Centers for Medicare and Medicaid Services on accountable care organizations, the American Hospital Association has asked for an easing or even elimination of regulations, such as the Stark Laws and other statutes regarding physician payments.

"It is important to understand, however, that many of these barriers need to be modified not only for ACOs but for all providers to respond to the behavioral changes required to address other ACA requirements such as reducing readmissions, adopting evidence-based medicine and payment bundling," AHA Senior Vice President Linda Fishman said in a letter to CMS Administrator Donald Berwick. "These barriers will get in the way of providers developing the clinical relationships needed to even prepare for an ACO role."

Fishman added that the current environment of medicine remains focused primarily on solo practice, and that most are banding together for single-specialty practices, not the multi-specialty practices that would best encourage care coordination. Without the relaxation of current anti-trust and anti-kickback laws, "the only options available to those in solo or small practices will be to become employees of the hospitals or to form large multi-specialty group practices," Fishman wrote.

Fishman also noted that the current regulatory environment would stifle creativity within ACOs, such as providing financial incentives to patients to adhere to their care regimens.

For more:
- read the letter here
- read the AHA News article

Suggested Articles

Two doctors would like to see a practice and policy "reset" post-COVID to help permanently reduce administrative headaches for physicians.

Ginger banked a $50 million funding round backed by the venture arms of Cigna and Kaiser Permanente. Here's how it plans to use the financing.

DOJ filed suit against Cigna on Tuesday, alleging that the insurer used a primary care program launched in MA to boost its risk scores.