The AAN has submitted comment letters to the Centers for Medicare and Medicaid Services (CMS), the Health and Human Services Office of Inspector General, and the Federal Trade Commission requesting improvements in the proposed rules for accountable care organizations (ACO). The proposed rules would set up a voluntary program where health care providers could join together in ACOs to coordinate and improve care. The ACOs would be responsible for the cost and quality of care, and would share in any savings or loses experienced by CMS.
After receiving several letters critical of the economics and complexity of the proposed rule from groups such as the American Hospital Association, the American Medical Association, and most notably, all the participants in the ACO pilot program (the Physician Group Practice Demonstration), CMS released new initiatives to make ACOs more attractive. The new initiatives would allow those organizations ready to form an ACO to do so immediately, provide shared savings in advance to ACOs to help them defray the start-up costs, and provide a learning center where physicians could learn how to set up an ACO.
The AAN's comments focused on ensuring neurologists will be able to participate in an ACO, or successfully operate a viable practice and deliver high quality care to their patients if they stay out of one. Specifically, the comments protect specialists' place in the care continuum by ensuring a patient's right to see the physician of their choice, advocating for quality measures that would enable neurologists to contribute and participate fully in their ACO's operation, and arguing for quality measures that would ensure patients receive the benefit of disease guidelines.