|June 6, 2011|
Previously published on June 6, 2011
The AHA and AMA also both weighed in on anti-trust concerns.
As discussed in past updates, the Federal Trade Commission (FTC) and the Department of Justice (DOJ) released a joint proposal in conjunction with the release of the proposed ACO rule that focuses on the anti-trust implications of the new ACOs. The agencies proposed to approach the anti-trust issue by dividing ACOs into three groups based on how much business is done in a specific geographic area. The ACOs in the largest category will be subject to a mandatory review process and will need that approval in order to move forward with implementation.
In response, the AHA conducted an analysis that found many of its member hospitals will be subject to the mandatory review process. The association expressed concern with this finding, despite promises from the FTC and DOJ that the process would be conducted quickly. The AHA stated: “This suggests that those seeking to build the most comprehensive ACO models of the future are the ones most likely to be ensnared in an uncertain, unappealable, burdensome and costly antitrust review before their merits as a force to transform health care delivery can be determined by CMS.”
On a related note, the AMA weighed in on the anti-trust proposal, stating that, as currently written, the proposal “¿could have a significant and negative impact on the ability of physicians, hospitals, and other eligible ACO entities to successfully form and participate in ACO models.” The association also stated: “If physicians cannot see a clear path to forming an ACO, these models will not achieve their full potential to increase care coordination and promote cost savings.”