HCI3 Update from the Field: Move Away from the Status Quo?

Submitted by francois.debrantes@hci3.org on Thursday, June 16, 2011 - 02:04

HCI3 Update from the Field – Newtown, CT

How can we move away from the status quo if we bake it into the design of new programs? We can't and shouldn't. Which is why I encourage everyone to carefully read the recent letter from the Consumer-Purchaser Disclosure Project to CMS on the proposed regulations for ACOs, a letter to which we've signed on. The point made is simple: it doesn't matter how many ACO-wannabes don't qualify (after all, that's why they're wannabes), what matters is that those that do are real ACOs and can prove it. As CMS designates these organizations to participate in the shared savings pilot, there will be an immediate imprimatur of superiority and a potential for bragging rights. Those should be doled out carefully, or Medicare beneficiaries and other consumers could simply be misled to being treated in a wannabe instead of the real deal. This is the same point I made, in vain, to the NCQA's Clinical Program Committee about the ACO Accreditation program that is in process of being finalized. Quite simply, it's awful. If it stands as currently designed, it will be accrediting a bunch of wannabes, and vastly misleading the public about the quality of care of these organizations. In protest, and to clearly express my dissent, I resigned from the NCQA's CPC.

What this means to you – Provider organizations that have been hard at work transforming their care processes and focusing on good outcomes should be the first to demand that ACO standards be tough. Payers, purchasers and patients have to do the same. Else we all simply risk projecting into the future the same failed organizations that don't deliver value today. This country will be better off if only a handful of true ACOs are identified, put into the spotlight and used by all others as beacons. What the whiners and wannabes are complaining about is that the standards are too tough. Really? Tell that to the patient who has an infection or an avoidable hospitalization. If we allow CMS or NCQA to lower the standards with which ACOs are measured, we won't be able to distinguish the wannabes from the real deals, and instead of looking for beacons of light we'll be waddling around in a fog of pretense. Time for everyone to strap on an extra pair of guts and do what's right for all Americans.


Francois de Brantes
Executive Director
Health Care Incentives Improvement Institute, Inc.