Leaders of the Campaign for Better Care, a broad-based coalition of consumer organizations, have come out in support of the Centers for Medicare and Medicaid Services' proposed rule for accountable care organizations, saying CMS is putting patients first.
CMS had issued the proposed ACO rule on March 31, with a comment period closing June 6.
[See also: Senators ask HHS to withdraw proposed rule for ACOs.]
"The CMS Medicare Shared Savings proposed rule is moving in the right direction," the coalition said in a statement. "The ACO proposed rule is premised on patient-centered care, patient engagement, a strong foundation of primary care, performance measurement including patient experienc and meaningful stakeholder involvement. These elements are the key to a successful ACO and genuine transformation of our care delivery system overall."
CBC officials said the government can't afford to set the bar too low when it comes to ACOs."Some are concerned about asking too much of ACOs, but we believe these new models must be held to standards that ensure they deliver on the promise of better care, better health and lower cost," the group said. "If the bar is set too low, ACOs will likely fail – either by failing to produce real results through a fundamentally different approach to care, or by creating resistance among patients who are called on to pay for or be part of mediocre attempts at change."
CBC officials said they support the requirement that ACOs meet eight specific criteria, including care coordination, patient engagement and the use of patient experience to assess care and guide quality improvement.
"These features are essential for ensuring that patients achieve better outcomes," the group said. "They are also important for reducing the costs of preventable hospitalizations, medication errors and duplicative tests and procedures."
CBC officials said the members of the coalition "strongly support" the proposal that Medicare beneficiary representatives be included on the governing board. An ACO governing board should be a multi-stakeholder body that operates in the public interest and reflects the community it serves as well those providing care, according to the group.
Beneficiaries and community-based consumer advocates should hold a sufficient number of seats on
the governing body to enable them to have meaningful influence on the organization and its operations, CBC officials said. The group recommended that CMS require half of the seats on the governing body be held by beneficiaries, community-based consumer advocates and other relevant stakeholders.
CBC officials also support allowing beneficiaries to seek care outside of an ACO."Negative experiences with early Medicare+Choice plans are still fresh in the minds of many, and if beneficiaries believe they are being locked in to a new system without their consent they are likely to reject it out of hand – jeopardizing the potential advantages that ACOs may bring to patients and the healthcare system," the group said.
[See also: AHA says start-up costs for ACOs higher than expected.]