Accountable Care Organizations part of cost-cutting CMS proposal

The medical device industry approaches with caution as the first major payment reforms of the Affordable Care Act are released by the Centers for Medicare and Medicaid Services.

The Centers for Medicare & Medicaid Services introduced a proposal to change the way hospitals are paid as part of President Barack Obama’s landmark health care reform law.

The proposal includes guidelines for so-called “accountable care organizations,” designed to help rein in unchecked health care costs by restructuring the fee-for-services system hospitals currently use.

The 430 page document includes several provisions intended to control those costs, according to the Medicare agency, which said the fee-for-service system contributes to the high cost of care in the U.S. that the Patient Protection & Affordable Care Act is meant to address.


“The Medicare Shared Savings Program will reward ACOs that lower health care costs while meeting performance standards on quality of care and putting patients first,” according to a press release from the U.S. Dept. of Health and Human Services. “Patient and provider participation in an ACO is purely voluntary.”

Learn more about how ACO rules will affect the medical device industry with MassDevice’s “Will ACO’s change the way you do business?” webinar

Federal officials have opened a three-week public comment period for the proposal and will be holding a series of “open-door forums and listening sessions.”

Under the proposed rules, teams of physicians, hospitals and healthcare providers would work together to coordinate health care for Medicare patients. The Congressional Budget Office estimates that as many as 40 percent of all Medicare beneficiaries will ultimately be enrolled in ACOs. More than 45 million Americans are covered by the federally funded program, a number that will grow as more of the Baby Boom generation retires.

Not surprisingly, the medical device industry responded with caution to the proposed changes. The industry has repeatedly warned that there is a risk that ACOs could keep the best possible care from patients and stifle innovation.

“We believe ACOs have the potential to improve the quality and efficiency of health care,” AdvaMed chief Stephen Ubl said in prepared remarks. “It is important, however, that ACOs be implemented with strong safeguards to assure that patients have access to the most appropriate treatment for their needs and that medical progress is not inhibited — particularly since most current quality measures do not sufficiently capture critical dimensions of good patient care.”

Medical Device Manufacturers Assn. president Mark Leahey said his members oppose “any program that would provide hospitals and physicians financial incentives to reduce appropriate care or use a particular type of device.”

The new ACO proposal includes guidance from the Federal Trade Commission, which is proposing an “anti-trust safety zone” to shield the organizations from the agency’s monopoly-busting power.

Health care law: Tilting at windmills dept. Republicans on the House Energy and Commerce health subcommittee voted yesterday to strip federal officials of some of the power to pay for health care reform without going through Congress, with their Democratic counterparts calling the move a bald attempt to de-fund the law. The move is uncertain to make it to the House floor and almost certainly won’t pass the Senate.

Tainted IV solution implicated in 9 deaths. Nine of 19 patients infected with bacteria might have acquired the infections from tainted IV solutions, according to Alabama health officials. The patients developed bloodstream infections from serratia marcescens bacteremia, which can be fatal. Although that bacteria was found in IV bags used to treat the patients, state and federal investigators haven’t definitively linked the bacteria with the deaths.

Doc watch: How will health care reform affect cardiologists? Drs. Bob Harrington and Kevin Shulman discuss how healthcare reform will affect the way cardiologists practice in this podcast from WebMD’s

ACC 2011 preview. Speaking of cardiology, here’s a preview of some studies slated to drop at the 60th Annual Scientific Session of the American College of Cardiology/i2 Summit, scheduled for April 2-5 in New Orleans:

  • Cohort A results from the Partner trial comparing 12-month outcomes among nearly 700 patients who received either aortic-valve surgery or transcatheter aortic-valve implantation with Edwards Lifesciences Corp.’s (NYSE:EW) Sapien device.
  • Two-year results from the EVEREST II study comparing Abbott’s (NYSE:ABT) percutaneous MitraClip device with surgery for mitral-valve disease.
  • Results from the Precombat trial of Johnson & Johnson’s (NYSE:JNJ) Cordis Cypher drug-eluting stent versus surgery for left-main disease.
  • Results from comparisons of Medtronic Inc.’s (NYSE:MDT) Endeavor and Abbott’s Xience V stent.
  • Results from the Platinum comparison of Boston Scientific’s (NYSE:BSX) Promus Element and the Xience V stents.
  • Results from the Isar-CABG comparison of the Cordis Cypher, the Boston Scientific Taxus and Yukon PC’s bioabsorbale, drug-eluting Isar stent.
  • Results from a study of PLC Systems’ (OTC:PLCSF) RenalGuard system for preventing contrast-nephropathy.
  • Results from a trial of CVRx Inc.’s carotid stimulator, the Rheos baroreflex hypertension system.
  • A nationwide review of 500,000 stenting procedures to examine what proportion of procedures are appropriate or inappropriate according to medical guidelines.

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