WASHINGTON – Premier has submitted policy recommendations to the Centers for Medicare & Medicaid Services regarding the structure and design of the Medicare accountable care organization program, mandated to begin by Jan. 1, 2012.
Executives from the Charlotte, N.C.-based healthcare network said its 43 pages of recommendations represent information gleaned from Premier's ACO collaboratives and member health systems.
"ACOs are designed to align healthcare providers who are willing and able to take responsibility for improving the health of a defined population," Premier officials said. "ACOs can do this by rewarding collaboration among providers, patients and other parties in healthcare to improve quality, enhance patient satisfaction and reduce costs, while removing barriers that impede care coordination in other parts of the healthcare system."
According to Premier, the design of the Medicare ACO program must be flexible enough to allow innovation, but rigid enough so that the initial ACOs in the program inspire confidence in the concept and identify the necessary ingredients to build the next generation of patient care.
Premier also recommended that ACOs should be people-centered and transparent. Officials said CMS should prepare educational materials around ACOs for beneficiaries, and beneficiaries should be given the opportunity to opt out of the program at any time.
In addition, they said, CMS should allow ACOs to offer beneficiaries non-marketing items and services that will increase engagement and improve care.
Premier also advised CMS to recognize physician assistants, nurse practitioners and certified nurse specialists as part of the clinical capacity calculation, and as eligible for bonuses.
"These practitioners will be central in developing a strong primary care base, particularly in rural and shortage areas," the letter said.
