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Dr. Donald Berwick’s Plan Gets a Very Bad Review from Doctors

John on May 12, 2011 at 10:16 am

It’s funny how top down plans for “bottom up” reform don’t always seem to work out. Yesterday the American Medical Group Association sent a letter to Dr. Donald Berwick letting him know that they are not impressed with the regulations coming out of his office:

On behalf of the American Medical Group Association (AMGA), I want to thank you and the Centers for Medicare and Medicaid Services (CMS) for your efforts in drafting the proposed rule (Proposed Rule) for the Medicare Shared Savings Program, better known as Accountable Care Organizations (ACOs). We believe ACOs have the potential to transform the delivery system from a volume-based, fragmented system to one that focuses on care coordination, technology, team-based care, and improved outcomes. We look forward to working with you and CMS as the Proposed Rule goes through the regulatory process.

it is overly prescriptive, operationally burdensome, and the incentives are too difficult to achieveAMGA will submit detailed comments to CMS on the Proposed Rule. We write today, however, to express our serious concerns over the direction of the Proposed Rule. On its face, it is overly prescriptive, operationally burdensome, and the incentives are too difficult to achieve to make this voluntary program attractive. As you know, most policy experts believe multi-specialty medical groups are best poised to become ACOs in the short term. However, in a survey of AMGA members, 93 percent said they would not enroll as an ACO under the current regulatory framework.

Ouch! The letter goes on to point out that the law of unintended consequences could take over:

if ACOs are not successful, we are concerned that the only alternative to future delivery system “reform” will be draconian cuts across the provider spectrum. Such an approach would not change the way we deliver health care and ironically, would likely result in greater volumes of services provided.

In other words, the way things now stand it would have been better to do nothing.

[HT: The Hill]

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