FTC Commissioner blasts ACOs

Federal Trade Commissioner (FTC) J. Thomas Rosch on Thursday blasted accountable care organizations (ACO) under health reform, arguing that ACOs would up costs and reduce quality care, contrary to their intent, reports Mass Device.

The antitrust agencies have raised a number of concerns, including the risk of ACO price fixing and market dominance, particularly regarding private payers, Rosch said at an antitrust conference last week.

Although the Congressional Budget Office estimates that Medicare will save $5.3 billion from ACOs in the next 10 years, Rosch said he was "skeptical that ACOs will actually lead to any net health care cost savings" and called the Centers for Medicare & Medicaid Services' (CMS) estimates of the Physician Group Practice Demonstration "overstated."

Rather, he continued, "The available evidence suggests that the cost savings to Medicare will be very small to nonexistent, and there is a substantial risk that any reduction in Medicare expenditures will simply be shifted to payors in the commercial sector."

Rosch pointed to the antitrust safe harbors in the 1990s that paved the way for joint negotiations by competing providers, calling them "loopholes" in antitrust laws.

Last month, FTC and the Department of Justice issued a final enforcement policy statement, in which certain organizations would not be subject to mandatory antitrust review if they already satisfy criteria of the Shared Savings Program. Rosch said that he regards ACOs as a form of clinical integration.

CMS estimates that 1 to 5 million Medicare beneficiaries will be aligned with 50 to 270 ACOs during the first four years of Shared Savings, according to Rosch.

For more information:
- read the Mass Device article
- check out the speech (.pdf)

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