Two congressmen are lobbying Medicare chief Donald Berwick to use caution when implementing accountable care organizations for fear that the new payment programs for doctors established by the healthcare reform act could lead to rationing of care and have a chilling effect on medical innovation.
In a letter addressed to Donald Berwick, Reps Jim Gerlach (R – Pa.) and Mike Thompson (D-Calif.) said that they shared the goals of moving from a fee-for-service model, but are “concerned about potential unintended consequences of the regulation that could prevent some patients from receiving the care most appropriate for their needs, discourage medical progress and possibly undermine economic growth and job creation.”
The new regulations aim to shift the business of health care delivery from a fee-for-service model to one that pays hospitals and care providers based on quality of care, coordination of care and cost-effectiveness. It’s slated to kick off on a voluntary basis January 1, 2013.
Gerlach and Thompson both hail from states with deep roots in the medical device industry and their arguments are quite similar to the concerns voiced by industry, namely that devices or diagnostic tests for patients could be held up due to payment restrictions and that a change in the way devices and diagnostics are paid for could have an overall chilling effect on innovative (but costly) medical devices coming to market.
The Congressional Budget Office estimates that as many as 40 percent of all Medicare beneficiaries will ultimately be enrolled in ACOs. There are currently more than 45 million Americans covered by the federally funded program, a number that will grow as more of the Baby Boom generation retires.
