The College of Healthcare Information Management Executives (CHIME), representing the nation's chief information officers, sent the Centers for Medicare and Medicaid Services (CMS) some hard-hitting comments about its proposed regulations on accountable care organizations (ACOs).
Among other things, CHIME objects to a provision that would allow Medicare beneficiaries who see a primary care doctor in an ACO to bar the organization from using their claims data to improve performance. While this opt-out provision on data sharing would be easier to administer than an opt-in provision, CHIME said, "it contraindicates efforts to provide accountable care....Further, it could potentially harm providers' ability to deliver quality care and it unnecessarily risks providers' chances of meeting the performance levels needed to qualify for shared savings payments."
CHIME recommends two alternatives to the proposed rule on data sharing:
1) Patients who object to the ACO using their data could be required to find another primary-care physician not affiliated with that ACO.
2) The ACO-participating primary-care physician could continue to see the patient, but that patient's healthcare expenditures would not be taken into account in determining whether the ACO is eligible for shared savings or has incurred shared losses.
In CHIME's view, the first approach would be simpler and more consistent with ACO goals. Moreover, the organization points out, the second alternative might induce certain providers to encourage high-risk patients to opt out of data sharing in order to boost their own incomes.
CHIME also took issue with other ACO regulations in the areas of meaningful use, quality reporting, and health information exchanges.
To learn more:
- read CHIME's letter to CMS (.pdf)
- see the Healthcare IT News story
- check out the Health Data Management piece