What was notable during today's conference call announcing the proposed accountable care organization rule is that CMS officials tried to allay concerns of commercial payers that ACOs would have too much pricing power in their local markets, says Chas Roades, chief research officer, health care, at the Washington-based Advisory Board Company, a consulting and technology services firm.
"CMS is very sensitive to the competitive marketplace implications of all this, they obviously got a lot of feedback and a lot of concern from commercial payers that ACOs will have too much market and pricing power in contract negotiations. It was apparent that HHS Secretary Sebelius have been working very closely with the Justice Department and the FTC to avoid that type of outcome," Roades says. "If you're a payer, one thing you're worried about with an ACO is that it's sort of a pseudo-insurance organization, it bears insurance risks for the health of a population and there are a lot of incentives to create some scale around an ACO to make it succeed. That has been worrisome to commercial payers."
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