More analysis of the proposed ‘ACO Rule’ from CMS from Vince Kuraitis on his e-Care Management blog. His eight ‘first impressions’:
1. The bar has been set high…very high. (At least 50% of primary care physicians must be meaningful user of EHRs by start of year 2)
2. Don’t expect to see many or any small ACOs. (His count is 75-150 ACOs–not the up to 1,000 originally estimated. And there’s downside risk.)
3. Patients will be confused by ACOs. (Patients are assigned to an ACO–they don’t sign up.)
4. Concerns over maintaining competition and avoiding antitrust are being taken seriously.
5. CMS scores points for coordinating the ACO Rule across Federal agencies.
6. CMS loses points for micromanagement and a controlling mindset. (Review and re-review of marketing materials. A 25% withholding on shared savings…when every penny counts at startup.)
7. Possible losers – hospitals, ACO vendors. (Does this mean telehealth?)
8. Possible winners – physicians, health plans. (Health plans can opportunistically support care providers and a more efficient care delivery system)
Bottom line: “Thus, at least for now ACOs will not be mainstream armies occupying every American community. Approved ACOs will be elite, highly trained and well equipped special forces units.” While Mr. K likes what CMS did with the ACO Rule…how do ACOs transform American healthcare as Mr Dishman foresees?
e-Care Management: Tire kickers need not apply