Proposal urges doctor-hospital collaboration
System’s goal is better care at lower cost
WASHINGTON – The Obama administration proposed new regulations Thursday to encourage doctors and hospitals to collaborate more closely to improve patient care, a major goal of the sweeping health care law the president signed last year.
The much anticipated rules will reward new partnerships, known as Accountable Care Organizations, that deliver better results for Medicare patients.
That could ultimately save taxpayers hundreds of millions of dollars by helping patients stay healthier and avoid unnecessary complications, according to proponents who view these new partnerships as one of the most potentially transformative parts of the new law.
“We’ve known for a long time that too many Americans fail to get the best care,” Secretary of Health and Human Services Kathleen Sebelius said Thursday. “It doesn’t have to be this way.”
It remains unclear how many doctors will sign up to start ACOs next year.
The Obama administration hopes many of the more than 45 million seniors and others who rely on Medicare will ultimately get their care this way; the administration’s early estimates are that about 1.5 million to 4 million people would participate by 2014, generating around $500 million in savings.
Some doctors fear that the new approach will unfairly advantage larger systems that can afford the computerized databases and other resources needed to coordinate care with hospitals and specialists.
American Medical Group Association Vice President Chet Speed said that the rigorous requirements for running an ACO and the risk of losing money may discourage many doctors from participating. “That’s going to be a difficult pill to swallow for many providers,” he said.
But many experts believe the ACO model could be replicated throughout the nation’s $2.5 trillion health care system, a process that has already begun as hospitals, doctors and health plans scramble to form new alliances.
“This is an important step,” former Medicare and Medicaid director Mark McClellan said Thursday.
ACOs present numerous challenges for federal officials, who spent the last year wrestling with how to encourage coordination without fueling too much consolidation in the health care system or repeating the mistakes of previous efforts to get patients into HMOs.
Critics say that could end up limiting patient choices and further driving up costs, a concern voiced repeatedly by insurance companies and others.
In an effort to address monopoly concerns, the Department of Justice and the Federal Trade Commission issued a series of guidelines Thursday designed to protect ACOs that have limited market share and subject larger organizations to antitrust review.