Tevi Troy suggests the answer is “yes.” He explains why in a Politico column about the so-called Accountable Care Organization.
If there was one element of the controversial Obama health care law that Republicans could have embraced as part of a bipartisan compromise, it was the concept of the Accountable Care Organization, a grouping of doctors and hospitals that provide treatment in a more efficient and cost-effective manner. Republicans, in fact, even included ACOs as part of the Patient Choice Act, their alternative to the health care bill.
While this GOP alternative had very few points of overlap with President Barack Obama’s health care law, it did call for ACOs that could “improve payment to physicians, hospitals, pharmacists and nurses for demonstrable improvements in quality and patient satisfaction while reducing costs.”
Unfortunately, when the Obama administration came forth with its proposed rule governing ACOs on March 31, it landed with a resounding thud. As The Washington Post noted in a piece about ACOs, “major groups of hospitals and doctors are skeptical of the government’s plans.” Instead of flexible organizations that encourage teamwork as a way of saving both providers and the government money, the Obama administration came up with an over-directed, 400-page proposal that provides economic disincentives to create ACOs and hoped-for cost-saving alliances.
One of the most onerous requirements is that ACOs have to track 65 different quality measures, an expensive proposition. The Centers for Medicare & Medicaid Services estimates that forming an ACO will require an initial investment of $1.8 million. An analysis by the American Hospital Association shows that startup costs will actually be in the $11.6 million to $26.1 million range.
