More than 40 health, consumer, disease-focused, aging and other state and national organizations are signing onto a letter organized by the Campaign for Better Care (CBC) that commends the Centers for Medicare and Medicaid Services (CMS) for its proposed rule on the Medicare Shared Savings Program — Accountable Care Organizations (ACOs). The comments will be filed later today and a summary is posted here.
The letter says, in part:
It is essential that CMS establish the right vision and direction for this program. Overall we believe you are moving in the right direction with the proposed rule, and we applaud your commitment to ensuring ACOs deliver truly patient-centered care. Changing the outcomes produced by our health care system requires genuine change in provider behavior and payment incentives, which will in turn drive patient outcomes, experience, and engagement. We know that true transformation of this magnitude is no small feat. It will require hard work by providers and payers. But we can no longer afford the status quo, either in financial or human terms. Patients and their families have long deserved better.
While some are concerned about asking too much of ACOs, we cannot expect genuine transformation to be easy, and we know that these new models must be held to standards that ensure they deliver on the promise of better care, better health, and lower cost. 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. We are very pleased that the guiding principles upon which the ACO proposed rule is premised include patient-centered care, patient engagement, a strong foundation of primary care, performance measurement including patient experience, and meaningful stakeholder involvement.
“The Campaign for Better Care is working to improve health care for the oldest and sickest patients,” said CBC leader Debra L. Ness, who is President of the National Partnership for Women & Families. “ACOs are critically important to achieving that goal and, if done right with the patient as the central focus, they will be a central component of our reformed health care system. We thank CMS for issuing a strong, thoughtful rule that can advance the kind of ACOs that work well for patients and their families.”
The Campaign for Better Care’s letter strongly supports the requirement that ACOs meet eight specific criteria including care coordination, patient engagement and use of patient experience to assess care and guide quality improvement. It calls for strengthening provisions that promote beneficiary, consumer and other stakeholder involvement in governance. It lauds the requirements for full transparency and notification of beneficiaries, as well as the provisions that allow beneficiaries to seek care outside ACOs if they wish. The Campaign also supports the provisions designed to meet the special needs of beneficiaries who are eligible for both Medicare and Medicaid, emphasizes the need to collect age, race, ethnicity, language, gender and disability data to identify and reduce disparities, and urges CMS to go further in establishing a meaningful grievance process for beneficiaries.
Signers to the letter will include the AFL-CIO, AFSCME, Alzheimer’s Association, American Heart Association, Center for Medicare Advocacy, OWL — The Voice of Midlife and Older Women, Health Care for All, National Family Caregivers Association, and many others.
[The complete letter is posted here.]