ACOs — Savior of Physician-Based Healthcare?
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Home Page > Law > Health and Safety > ACOs — Savior of Physician-Based Healthcare?
ACOs — Savior of Physician-Based Healthcare?
Posted: Jun 08, 2011 |Comments: 0
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I recently met with a large group of unaffiliated physicians who were worried about how to survive in this era of tightened budgets and schizophrenic healthcare reform. They had decided to form a large multi-specialty group, and be their own accountable care organiztion, or ACO, in the hope of controlling their care of their patients.
It is necessary for physicians to come together to form new delivery systems for patient care. It is exciting. It is also scary. Healthcare is not for sissies.
Physicians have an opportunity that will not last long to retake the healthcare delivery system for their benefit and for the benefit of their patients.
So, it is time for physicians (if they haven’t already — which they should have been) to get educated about ACOs and what they mean to their practice of medicine. ACOs can provide a method for physician practices to remain independent. ACOs can also promote the consolidation of physician practices into larger single-specialty and multi-specialty groups. ACOs can also lead to the employment of physicians by hospitals and other large integrated healthcare delivery systems.
We all know that patients want physicians who care about them and will take care of them. Economics are important, but no one wants his or her healthcare to be so managed and so strained through insurance company and regulatory filters that it looks like the only thing that matters are the economics.
The heartbreak for so many physicians is that they cannot do what they went to med school to do — take care of people. Physicians have been forced to deliver the minimum amount of care, in the shortest time, to the maximum number of patients. The comfort of a trusted physician is what patients want.
ACOs may provide the mechanism by which physicians can reclaim the practice of medicine as a calling. Or, they can let the actuaries, accountants, and lawyers make the important decisions about healthcare.
Being proactive, being smart, and being cautious are critical to suviving as an independent healthcare provider.
However, setting up an ACO is not intended to be easy. On March 31, 2011, we were presented with hundreds of pages of paper from CMS, the FTC, and the OIG, offering us guidance on how to proceed. Here’s what we know so far:
CMS published its proposed regulations implementing Section 3022 of the Health Care Reform Act relating to payments to providers and suppliers participating in ACOs.
The OIG published its notice relating to the application (and waiver) of certain fraud and abuse laws in connection with ACOs.
The FTC and DOJ published their proposed statement of antitrust enforcement policy relating to ACOs.
These are only proposed at this stage, but the comment period on the CMS regulations ended on June 6. We can expect in a couple of months revised (final?) regulations. After that, I suspect that we will see things start moving very fast.
Standing still is an option for only the very short term.
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About the Author:
My name is Joseph Rugg. I am an attorney in the Healthcare Practice Group of Akerman Senterfitt. I am resident in the firm’s Tampa, Florida office. You can learn more about the firm here.
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