7 Senators say ACO model doomed to failure

By Stephanie Bouchard
01:13 PM

Seven U.S. senators have asked the Department of Health and Human Services to withdraw its proposed rule governing the Patient Protection and Affordable Care Act’s accountable care organizations because “it misses the target” of better care at lower costs.

The seven Republican lawmakers sent a letter on Tuesday to HHS Secretary Kathleen Sebelius and Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, expressing concerns about HHS’ proposed regulations for ACOs.

[Related: ACO regs take another beating. Editor's Desk: This Week in Government Health IT.]

The senators – Tom Coburn (Okla.), Jon Kyl (Ariz.), Mike Crapo (Idaho), Mike Enzi (Wyo.), John Cornyn (Texas), Pat Roberts (Kansas) and Richard Burr (N.C.) – said prominent healthcare providers such as the Cleveland Clinic, Mayo Clinic and Sutter Health and all 10 members of CMS’  Physician Group Practice demonstration project have reservations about the proposed rule.

They also noted a recent American Hospital Association report which found that ACO start-up costs are likely to be significantly higher than what CMS has estimated.

The senators said they believe ACOs show promise, but they think the model is doomed to failure under the proposed regulations. They said there's no alignment between incentives and accountability, the requirements are too complex and the return on investment is uncertain.

The senators suggested re-engaging with the healthcare community to “redesign a regulation that will truly help accomplish our shared goals for patients, providers and taxpayers alike: Better care at lower costs.”