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Originally Posted by TheMercenary
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...A bigger sticking point could be antitrust rules that are part of the ACO proposal. Mayo already provides most or all of the health care in many of Minnesota's rural counties, and Wood believes it could not operate ACOs in those areas without violating the proposed regulations.
Another issue is the way the government plans to measure effectiveness and its way of assigning patients to ACOs. The effectiveness measures proposed by the government are such things as 30-day mortality statistics and the number of diabetes treatments, Wood said.
"They don't get you close to measuring health," he maintained. "The simplest measure for consumers is: How effectively did the organization keep me functioning. People feel strongly that they want to be able to do what they need to do so that people who depend on them can continue to depend on them."
Mayo is confident enough in its current approach to accountable care that it has asked CMS "to take an entirely different approach to implementation of ACOs in the country." Mayo would like the government to contract directly with groups that are already providing programs.
CMS declined to comment on Mayo's concerns.
"This is a proposed rule," a spokeswoman said. "We will review the comments [provided by all organizations] and issue a final rule. We're confident providers will decide to participate based on the final rule, not the proposed rule."
Wood said Mayo is only interested in working in ways that are proven.
"We're not looking to intentionally give [health care reform] a black eye," Wood said. "We're working to implement accountable care."
Jim Spencer • 202-408-2752 • jim.spencer@startribune.com
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A couple observations here.
It's a proposed rule, not a final rule. This is a perfect example of how and why such an enormous problem like the runaway costs for healthcare needs to be addressed in a sensible way. By sensible, I mean in a thoughtful way. In this case, the government is including the thoughts of the provider, working for the interests of the citizens. I like that configuration. *And*, I think the ideas behind this part of the rules are good ones. I want Accountability. Including input from those outfits that will deliver it is sensible.