The time is now for ACOs, former CMS administrator says

Mark McClellan, MD

With the prohibitive and rising cost of healthcare, there has never been a greater need for accountable care organizations, according to Mark McClellan, MD, former administrator for the Centers for Medicare and Medicaid Services.

McClellan's comments came by way of a plenary speech given Monday at the National Health IT and Delivery System Transformation Summit, held in conjunction with Second Annual National Accountable Care Organization Summit June 27 and 28 in Washington, DC.

The challenge of achieving better care at lower costs has never been more important or more urgent, he said, and the serious challenges of getting from here to there have never been more daunting.

[See also: Top 4 obstacles to ACO formation.]

McClellan, who is now the director of the Engelberg Center for Health Care Reform at the Brookings Institution, said in the past year the Centers for Medicare and Medicaid Services (CMS) has identified many of the challenges faced by providers when starting an ACO, and there are now some successful ACOs from which to draw experience.

"ACOs are about fundamental changes," he said. "The main emphasis is to get away from fee-for-service payment structures."

He added that "ACOs are not going to be an immediate solution to all [U.S. healthcare] problems, but neither is anything else."

Despite the difficulties faced in launching ACOs, McClellan predicted ACOs "aren't going away."

ACOs are part of the Affordable Care Act, a comprehensive strategy to get better care at a lower cost. "They are not a bunch of reforms we're throwing up against the wall to see what sticks."

Some of the difficulties cited by stakeholders regarding ACOs are are costs, physician buy-in and interoperability.

[See also: Mostashari's ONC won't be as 'easy' to run as Blumenthal's.]

McClellan predicted the final ACO rule, expected out this summer, should have "a lot of changes" in it compared to the March proposal.

Department of Health and Human Services Secretary Kathleen Sebelius, who also spoke at the conference?s opening session, said HHS has "listened" and weighed the interest of stakeholders after proposing the ACO rule in March. Since then, HHS has received 1,200 comments, she said.

HHS is looking for ways "to find the best balance" between stabilizing costs and protecting patients, she said, adding that the ACO model will reward physicians for keeping their patients healthy in the first place.

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