ACO Rules Revised to Entice Greater Participation

The latest ACO rules revision; requires half the number of performance measurements, removes the electronic health records requirement and eliminates financial risks for some groups. CMS also relaxed the timetable for the launch of the ACOs with groups allowing them to apply throughout 2012. To entice providers, CMS said it will make $170 million available starting next year to physician-owned and rural providers to start ACOs (Gold and Galewitz, 10/20).

ASA Urges MedPAC to Reject SGR Draft Plans to Cut 18%

On October 5 and 6, 2011, the Medicare Payment Advisory Commission (MedPAC), the commission tasked with advising Congress on Medicare payment issues, will meet to review a draft recommendation that would help cover the costs of SGR repeal by cutting payments to specialty physicians, such as anesthesiologists, by nearly 18 percent over three years. 

In a letter written to MedPAC in response to the proposed plan, ASA President Mark A. Warner, M.D., expresses strong opposition to the commission’s draft recommendation.  Dr. Warner writes, “While we support permanently fixing the SGR, we believe cutting payment for anesthesia by 5.9 percent each year over the next three years, followed by a freeze in payment would harm patient access to care and does not take into account that Medicare currently pays anesthesiologists only 33 percent of the average commercial insurance payment for the same service.”

The proposed 10 year plan would differentiate specialty physicians from primary care physicians in regards to Medicare payments.  For specialty physicians, the draft recommendation would reduce payments 5.9 percent annually in years 2012, 2013 and 2014, followed by payment freezes for the final seven years. Payments for primary care specialties would be exempt from the payment reductions and would instead be frozen at current 2011 levels for the entirety of the 10-year period. 

ASA will continue to update members on the latest MedPAC developments.