Sebelius: ACOs can be hospital-free

Doctors have told Department of Health and Human Services Secretary Kathleen Sebelius that they're concerned accountable care organizations could become dominated by hospitals and force physicians to give up their small or independent practices. They need not worry. Sebelius told MedPage Today this week that accountable care organizations don't need to contain hospitals.

"I just want to assure folks that that is not the intent," she said. HHS would like to see a lot of different models of innovation and care delivery emerge. "We think a number of them should be provider-driven, not even connected to hospitals," she added.

She seems certain that once initiatives get under way, some of the myths surrounding what an ACO is or isn't will be dispelled.

When asked why the budget includes a two-year fix rather than a permanent one, Sebelius said that the administration would have to work with Congress to come up with the resources for a long-term strategy.

"The president has said from the beginning of his administration that this year by year kind of kick-the-can approach to [sustainable growth rate] doesn't work for patients, doesn't work for doctors, isn't good for the Medicare compact," she told MedPage. She added that he wanted to start with a proposal that put money in the budget, and that there's actually about two-and-a-half years worth of offsets to start with.

"We're hopeful that Congress would pass this," she said, "which frankly would be the longest SGR fix in a while, and then immediately come back to the table and work with us on what is a permanent fix."

To learn more:
- watch MedPageToday's full interview with Sebelius

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