The physicians were at the annual meeting of the California Association of Physician Groups, which represents large medical groups that receive set payments from managed care plans—closer to the ACO model than the fee-for-service payments common in other states.
ACOs were “the main buzz in speeches and hallway conversations,” the Desert Sun reported. But even these capitated groups would need to make adjustments for ACOs, speakers said. “We’re thinking incrementally,” said the group’s president, Donald Crane. “How many more hospitalists, how many more managed care specialists will we need to add to the competence of the group?”
Richard Gilfillan, MD, acting director of HHS’ Center for Medicare and Medicaid Innovation, tried to answer the physicians’ concerns in a speech to the group. In answer to the concern that proposed ACO payment formulas, detailed in draft regulations on March 31, may be too low, he encouraged association members to suggest changes. There is a “dynamic tension” between federal rule-makers and physicians in the field, he said.
“The ACO regulations were our best shot,” Dr. Gilfillan said. “We’re looking for real engagement. We are putting systems in place to see what better health looks like, what better care, what better cost looks like for the nation. We’re after a coordinated system that’s accessible and affordable.”
Read the Desert Sun report on ACOs.
Related articles on concerns about ACOs:
ACOs Could be Stymied By Data Problems, NCQA Head Says
Federation of American Hospitals Objects to NCQA Draft Criteria for ACOs
Former HHS Official Says ACOs Are a Joke
