• ACO runback

    Is Don Berwick listening to complaints about ACOs? When highly integrated groups like the Cleveland Clinic and InterMountain said they couldn’t cut through the complex ACO payment rules, it seemed like a death knell. Until yesterday’s press release.

    • CMS announced the new “Pioneer ACO” model for “mature” provider organizations. No rules out yet, just the promise that the rules will be vastly simplified for groups that are already integrated. And they are in a hurry – the letter of intent to participate is due June 10, 2011.
    • The second walkback is even more amazing – bribing paying other provider groups to create ACOs. This “Advance Payment ACO Initiative” will pay ACO bonuses in advance. I’m stunned. Pay-for-future-performance.

    This isn’t a walkback, it’s a runback.  h/t to KFF.

    Updated to add Harold Pollack’s guest post on ACO regulatory problems.

    • The Advance Payment is big news. Most hospitals are feeling a bit of a crunch secondary to the weak economy. We have been worried about how to fund a switch away from a FFS model. This could make it much easier to transition.