While Leapfrog and its purchaser members appreciate the potential value of Accountable Care Organizations to improve patient care, the final regulations issued by CMS do not require the level of transparency and accountability employers and other purchasers need to have confidence that ACOs will indeed improve patient care. There is no requirement that quality data about the performance of individual providers and hospitals and/or the ACO as a whole be made public. The quality and safety data ACOs are required to collect does not account for outcomes or for the appropriateness of treatments, even though the structure of ACOs creates financial incentive for hospitals to lean toward invasive, high-cost procedures. The regulations require that the governance structure of ACOs be at least 70% providers, assuring that community organizations and purchasers will not have significant leverage to influence the strategy of any ACO.
CMS has made a commitment to align initiatives like ACOs with private sector initiatives to improve quality. These regulations lack the public accountability necessary to achieve that goal immediately, but we trust that this is just the first step in launching ACOs and look forward to alignment in the future.
Please refer to the press release issued by CMS for more information.
Leah Binder, CEO, The Leapfrog Group