Senators Request Withdrawal Of Proposed ACO Rule

Claiming that it “misses the target” of better care at lower costs, seven U.S. senators have asked the Department of Health and Human Services (HHS) to withdraw its proposed rule governing accountable care organizations (ACOs) established under the Patient Protection and Affordable Care Act. The seven Republican lawmakers made their request in a letter Tuesday to HHS Secretary Kathleen Sebelius and Donald Berwick, administrator of the Centers for Medicare and Medicaid Services (CMS). Expressing their concerns about HHS’ proposed regulations for ACOs, the senators – Tom Coburn (Oklahoma), Jon Kyl (Arizona), Mike Crapo (Idaho), Mike Enzi (Wyoming), John Cornyn (Texas), Pat Roberts (Kansas), and Richard Burr (North Carolina) – claim in the letter that such prominent healthcare providers as the Cleveland Clinic, Mayo Clinic, and Sutter Health have reservations about the proposed rule. So, too, they say, do all 10 members of CMS’ Physician Group Practice demonstration project. In explaining their concerns, the lawmakers cite a recent American Hospital Association (AHS) report, which found that ACO start-up costs are likely to be significantly higher than those initially estimated by CMS. The letter also expresses the senators’ belief that while ACOs themselves show promise, the model is doomed to failure under the proposed regulations. The lawmakers claim that there exists no alignment between incentives and accountability, that the requirements are too complex, and that the return on investment is uncertain. Finally, the senators suggest re-engaging with the health care community to “redesign a regulation that will truly help accomplish our shared goals for patients, providers and taxpayers alike: Better care at lower costs.”