Accountable Care Orgs and Other Medicare Innovations Come Under Congress’s Microscope

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Accountable care organizations and other “experiments” designed to reduce the cost of healthcare are drawing fire from Congress’s Republicans, Politico reports, who attacked the main proponent of those experiments, the Center for Medicare and Medicaid Innovation (CMMI).

In a hearing Wednesday, Republican members of the Senate Finance Committee criticized CMMI, claiming its projects are too similar to other similarly funded projects underway at the Centers for Medicare and Medicaid Services, as identified in a recent Government Accounting Office audit. “We’re in the middle of sequestration, [and] agencies have been told to scale back … do you think it’s appropriate for CMMI models that clearly overlap?”asked Senator Chuck Grassley (R-Iowa).

Sen. Pat Roberts (R-Kan.) complained that accountable care organizations don’t work in rural areas because of the sparcity of doctors.

Richard Gilfillan, director of CMMI, defended the agency’s projects and said there was preliminary data that indicated it was reducing costs and improving outcomes. But the real proof will come in the summer, when CMMI will receive data from the first accountable care organizations.

No formal action against CMMI or its $10 billion budget was taken by the Republicans or the Finance Committee. But Sen. Orrin Hatch (R-Utah) offered his prediction: “Come the first part of next year, this is going to be utter chaos, and people will realize what a mess we’re in,” he said.

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Posted in Denials Management, Medical Receivables, Patient Experience, Patient Financial Services .

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