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AMA registers concern about regulatory burdens related to accountable care organizations
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The American Medical Association has raised concerns about a proposed Federal Trade Commission and Department of Justice policy regarding accountable care organizations, according to a news release from the organization.
Michael D. Maves, MD, MBA, executive vice president and CEO of the AMA, sent a letter on May 26 to FTC Secretary Donald S. Clark expressing trepidation about the policy on the enforcement of antitrust policy relating to accountable care organizations (ACOs).
ACOs — collaborative entities comprising primary care physicians, hospitals and other professionals — will be eligible to participate in the Medicare Shared Savings Program starting Jan. 1, 2012. The Centers for Medicare and Medicaid Services issued a preliminary rule on ACO participation in March and is expected to release a final rule in October. The savings program is designed to coordinate care and make care more efficient.
Cecil B. Wilson, MD, president of the AMA, expressed concern in the release that the ACO policy may undermine the ability of physicians in small practices from participating in ACOs.
“As proposed, the FTC and DOJ policy on ACOs simply does not go far enough to level the playing field, leaving small physician practices at a disadvantage compared to hospitals and dominant insurance companies,” Wilson stated in the release.
Under the proposed policy, an ACO that controls less than 30% of a designated public service area would be eligible for protection from antitrust law. The threshold should be increased to 40% for ACOs that face competition from other providers, the letter said.
William L Rich III, MD, American Academy of Ophthalmology director of health policy, expressed opposition to a provision of the policy calling for physicians in smaller markets to sign exclusive contracts with ACOs.
“This is fine for primary care docs whose panels may be almost entirely filled with ACO patients,” Rich told said. “This should not apply to specialists. … To force them to sign an exclusive contract would severely limit their access to patients in competing ACOs and might prevent the development of physician panels by new ACOs who want to enter the market.”
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