Cleveland Clinic, leading hospitals blast ACOs

Similar to some other renowned health systems, Cleveland Clinic CEO and President Delos M. Cosgrove, MD, condemned federal rules of the accountable care organization (ACO) proposal released in March. In a May 26 letter to CMS Administrator Don Berwick, MD, Cosgrove noted that Cleveland Clinic supports the concept of ACOs but adamantly rejects the proposed rules that are "replete with (1) prescriptive requirements that have little to do with outcomes, and (2) many detailed governance and reporting requirements that create significant administrative burdens," he stated in the letter.

"Further, we have concluded that the shared savings component (Shared Savings) is structured in such a way that creates real uncertainty about whether applicants will be able to achieve success."

Cleveland Clinic isn't alone. Other heads of leading hospitals have not immediately embraced the proposed ACO rules for administrative burdens, including Mayo Clinic, Geisinger Health System, and Intermountain Healthcare. Executives from the health systems have expressed concerns about proposed requirements that would allow patients on governance boards, extensive ACO application requirements, strict patient-centered marketing guidelines, and most notably, shared savings.

The final rule is expected to be released in August with a start date of Jan. 1, 2012, both of which health organizations have criticized as too soon for adequate comment review.

To learn more:
- read the MedCity News article
- find the Cleveland Clinic letter (.pdf)
- read the Commonwealth Fund article

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