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June 13, 2011

No to ACO

Daily Briefing

Mayo Clinic officials last week outlined the key reasons why it does not plan to participate in the proposed Medicare accountable care organization (ACO) program, the Minneapolis Star Tribune reports.

CMS in March released its proposed shared savings rule, which would govern ACOs, as called for by the federal health reform law. Lawmakers intended that networks of providers would form ACOs to collaborate on care for Medicare beneficiaries, improve outcomes, reduce cost, and share in savings.

However, the American Medical Group Association—a trade association that represents major multi-specialty health organizations such as Mayo and the Cleveland Clinic—has warned that 93% of the organization's members will not participate in the program as currently written.

According to Mayo, the program will conflict with the way the clinic manages Medicare operations, the Star Tribune reports. For example, the program requires patients to be included on boards that review performance, which Mayo's chair of health care policy and research says is not necessary to provide patient-centered care.

However, a "bigger sticking point" may be the program's antitrust rules, the Star Tribune reports. Mayo currently provides most of the medical care in rural Minnesota communities, which could violate the regulations. Mayo officials also believe that many of the quality measures included in the ACO program fail to adequately measure effectiveness.

The Rochester, Minn.-based clinic last week sent a nine-page letter to CMS asking the agency to adopt an "entirely different approach to implementation of ACOs in the country." According to a CMS spokesperson, the agency will review all comments before issuing a final rule and is "confident providers will decide to participate based on the final rule" (Spencer/Herb, Star Tribune, 6/10).

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