Don Berwick Comments on Goals for ACOs and Role of Federal Oversight

Kicking off a day-long federal listening session with stakeholders, CMS Administrator Don Berwick, MD, outlined his concept of the accountable care organization and how federal agencies should oversee ACOs.   

He said federal regulators tailoring antitrust and fraud and abuse laws to accommodate ACOs have a fine line to walk. The legal goals for ACOs should be "cooperation without corruption, aggregation without hegemony and synergy without collusion," he said. In return, ACOs need "clarity and predictability about the regulatory regime."

Dr. Berwick repeated his "triple aim" for ACOs, which was frequently mentioned later during the conference, that an ACO should provide "better care for individuals, better health for populations and lower capital costs without any harm whatsoever to patients." He added that ACOs should not be recycling old ways of delivery models, but should be developing new and better methods to provide care.  

He mentioned five expectations for ACOs:

  1. Reducing dependence on hospitals. Instead, "patients will be home where they want to be," he said.
  2. Using a proactive approach. ACOs will advance ways to help people stay healthy, he said.
  3. Using a rich trove of healthcare data. ACOs will use data-driven approaches such as patients registries.
  4. Taking an innovative approach. ACOs will draw upon the best advances in models of care. "We want to help integrated care to thrive in America," he said.
  5. Maintaining and executing plans. "I don’t view the ACO as primarily a financing mechanism," Dr. Berwick said. "It's a care delivery system."

Read the agenda of the listing session (pdf).


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