Groups submit comments on ACO rule

Monday, July 25, 2011

WASHINGTON - Industry stakeholders in early June weighed in on CMS's proposed rule on accountable care organizations (ACOs).

"We suggested that the ACO structures should include homecare and HME as an element," said Wayne Stanfield, executive director of NAIMES, which submitted comments. "DME providers play a vital role in reducing hospital readmissions."

The Affordable Care Act of 2010 included a provision that would incentivize hospitals and physicians to work together--as ACOs--to keep patients out of the healthcare system as much as possible. CMS issued a proposed rule outlining how it plans to implement the provision April 7.

HME providers are not explicitly mentioned in the proposed rule. That's not necessarily a bad thing, say industry stakeholders. The proposal is "very controversial" at this point, said Cara Bachenheimer.

"It is viewed as being extremely restrictive and extraordinarily difficult to comply with," said Bachenheimer, senior vice president of government affairs for Invacare. "The physician and hospital community has made a huge outcry about it."

Still, many in the industry believe that ACOs could provide an opportunity for providers who can align themselves with ACOs based on their proven ability to improve outcomes. 

"They are going to want to work with post-acute providers that do a good job of providing quality care at a lesser cost," said Bachenheimer. "You'll be shut out if you don't convince the hospital and physician folks that you are a good and cost-effective provider."

That was the message AAHomecare had for CMS in comments it submitted on the rule.

"Our goal is to make sure that HME providers are included in the mix because of our cost-effective nature," said Walt Gorski, vice president of government affairs. "If this is a trend that is going to take off, we want to ensure that HME providers have the ability to participate."