June 22nd, 2011

Potential Savings of Key Obamacare Program Overestimated

The estimated potential savings of Obamacare’s Shared Savings Program (SSP) may have to be downgraded according to a recent letter from the American Medical Group Association (AMGA) to the White House’s Office of Management and Budget (OMB). Read more »

June 5th

CMS Wants Control of ACO Marketing Materials

The Centers for Medicare & Medicaid Services, by requiring preapproval of all Accountable Care Organization marketing materials, violates its own vision statement. CMS is acting less like a “trustworthy partner for the continual improvement of health and health care for all Americans” and more like a jealous and controlling lover. Read more »

June 2nd

CMS Wants to Control How ACOs Use Profits

In its proposed regulation on the Medicare Shared Savings Program for Accountable Care Organizations, CMS seems disappointed that it can’t control how the distributions from shared savings will be used. So the proposed regulation does the next worst thing: it regulates the distributions by requiring the ACO to determine ahead of time how the funds will be used. CMS seems to go as far as to expect ACOs to specify “how [the shared savings] might be invested in infrastructure and redesigned care processes for high quality and efficient health care service delivery.” Read more »

June 1st

CMS Interfering in Health Provider Board Rooms

Under a regulation proposed by the Obama Administration, an ACO that wishes to participate in the Shared Savings Program must have at least one Medicare beneficiary on its board of directors. The administration laments the lack of control that Medicare beneficiaries have over health provider organizations. But they do not consider that all patients—whether Medicare beneficiaries or otherwise, have the ultimate power of market choice. Read more »

May 16th

Our Comment on Obamacare's State Innovation Waivers

Last week, we submitted a comment to the Obama Administration on its State Innovation Waiver proposed regulation. Read more »

Now Nursing Homes Are Asking for Obamacare Waivers

Since Obamacare was rammed through Congress, we have been discovering the potential unintended consequences of the Act. Waivers have been issued by the Obama Administration, for instance, to prevent the lapse of coverage for low income workers and college students. Now, the New York Times reports that nursing homes are seeking relief from Obamacare. Read more »

May 11th

Now Even Large Hospital Systems are Running from Obamacare's ACO Regulation

Obamacared's Accountable Care Organizations have been criticized as only feasible for large organizations such as hospitals. But the Obama Administration's proposed regulation on Accountable Care Organizations is so burdened by restrictions, mandates, and penaties, that now even hospitals are saying they won't participate in the voluntary program without "substantial revisions." Read more »

May 4th

Obama Administration "Defensive" of Proposed ACO Regulation

Modern Healthcare reports that officials at the Centers for Medicare and Medicaid Services (CMS) are on the defensive after their proposed regulation on Accountable Care Organizations (ACOs) has received high levels of criticism from even those in favor of ACOs in theory. Read more »

May 3rd

Just What is an ACO?: A Brief Introduction to Accountable Care Organizations

"The accountable care organization is like a unicorn, a fantastic creature that is vested with mythical powers. But no one has actually seen one."

A mere six pages of Obamacare legislation delegated broad jurisdiction to the Secretary of Health and Human Services (HHS) to establish an Accountable Care Organization (ACO) program. The term “Accountable Care Organization” was coined in 2006. And there has been a couple of federal pilot program testing the idea. Yet without a regulation defining and establishing ACOs, most could only speculate on what one is.

But, on April 7, 2011, HHS took their six-page directive from Congress and turned it into a 127-page proposed regulation. We now have a better idea of what an ACO is and is not.

Here is our brief summary. Read more »

April 26th

Christie Administration Harshly Criticizes Obamacare Rate Review Regulation

From time to time we check back on Obamacare regulations after their comment periods have closed to see what others are telling the Obama Administration about these regulations.

Thomas Considine, Commissioner of New Jersey’s Department of Banking and Insurance under Governor Chris Christie, submitted a comment to the Department of Health and Human Services (HHS) on February 14, 2011 soundly criticizing HHS's insurance rate review regulation. Read more »