Specialists question ACO integration, show reluctance to join

Organizations representing oncologists and other specialty physicians are expressing some concerns about how accountable care organizations will be regulated, reports AIS Health.

Officials with U.S. Oncology, a cancer-focused medical group involved with setting up an ACO in Texas, has asked the Centers for Medicare and Medicaid Services for more details on how ACOs would operate. "It is currently unclear under the CMS proposal whether Medicare beneficiaries fighting cancer will benefit from the oncology-related quality and cost improvements ACOs are intended to deliver," the organization wrote to CMS.

Conversely, specialty groups are showing reluctance about joining ACOs. "Specialists are not taking the lead in the formation of ACOs,"  Aric Sharp, CEO of the Quincy Medical Group, a 130-provider multi-specialty group in Illinois, told Becker's Hospital Review. "The physicians who are interested are in multi-specialty groups or integrated models with hospitals."

Jack Lewin, MD, CEO of the American College of Cardiology, also observed that it could be difficult to integrate specialty physicians, payers and hospitals in an ACO model under the current Medicare fee-for-service payment structure.

"It's going to be tough to get the coordination between primary and specialty care," Lewin said, unless all of the doctors opt into Medicare in a specific community.

Lewin's organization supports a special registry that would track individuals receiving care in both the inpatient and outpatient spectrum, but he noted that the proposed ACO regulations do not call for such a registry.

For more:
- read the AIS Health article (reg. req.)
- read the Becker's Hospital Review article