Saturday, July 04, 2020
Hawai'i Free Press

Current Articles | Archives

Wednesday, June 01, 2011
After Rejection by Mayo Clinic, US Senators ask Obama Admin to withdraw Medical Home Regs
By News Release @ 11:09 PM :: 5503 Views :: Energy, Environment, National News, Ethics

…will US Senators once again save Hawaii from its elected officials?  NO other Hawaii media organization has covered this story….

News Release from American Academy of Orthopedic Surgeons

(Note, the plan referred to by Gov Neil Abercrombie as “Medical Homes” is identified as ACOs or Accountable care Organizations in this report from the American Academy of Orthopedic Surgeons and the US Senators’ letter.)

In a letter to the secretary of U.S. Department of Health and Human Services (HHS) and the administrator of U.S. Centers for Medicare & Medicaid Services (CMS), seven members of the U.S. Senate Finance Committee have raised concerns over a proposed rule regarding the implementation of accountable care organizations (ACOs) under the Patient Protection and Affordable Care Act. The legislators state that a number of medical organizations, including "all ten members of the nationally recognized Physician Group Practice (PGP) CMS demonstration project" have expressed reservations over the regulation. In addition, the writers point out that a recent report from American Hospital Association estimated that ACO startup costs would be at least 10 times higher than costs cited in the proposed rule. The senators have asked HHS to withdraw the proposed rule and craft a new version with input from stakeholders.

PDF version of the letter HERE.

  *   *   *   *   *

May 24, 2011

The Honorable Kathleen Sebelius U.S. Department of Health and Human Services 200 Independence Avenue, SW Washington, DC 20201

The Honorable Donald W. Berwick, M.D. Centers for Medicare and Medicaid Services U.S. Department of Health and Human Services 200 Independence Avenue, SW Washington, DC 20201

Dear Secretary Sebelius and Administrator Berwick:

We are writing to express our serious concerns regarding the Department of Health and Human Services’ (HHS) recently-proposed regulation implementing Section 3022 of the Patient Protection and Affordable Care Act – the Medicare Shared Savings Program, commonly referred to as Accountable Care Organizations (ACOs).

Rewarding high quality, efficient providers based on positive patient outcomes in an ACO model is a concept that sustained bipartisan support throughout the contentious health care debate of the 111th Congress. Accordingly, we sincerely appreciate the time and effort the Administration has invested in developing the draft ACO regulation.

However, we have been struck by the increasingly diverse chorus of concerns many of our nation’s leading health care institutions have raised in recent days about the proposed ACO regulation. Innovative integrated health providers as the Billings Clinic (MT), Intermountain Healthcare (UT), the Cleveland Clinic (OH), Mayo Clinic (MN), Sutter Health (CA), Marshfield Clinic (WI) have expressed serious concerns with the details of the proposed rule.

These providers are not the only ones concerned. In fact, all ten members of the nationally-recognized Physician Group Practice (PGP) CMS demonstration project have expressed “serious reservations” about the regulation’s current construction. It is troubling that their participation is doubtful, since these PGP members and experience are cited more than 75 times in your Agency’s 400+ page proposed rule as a model for the ACO regulation.

One clear disincentive was identified last week. The American Hospital Association released a report noting that actual ACO start-up costs will likely be at least 10 times higher than the estimated costs cited in the proposed rule.

The concerns over the ACO regulation from some of our nation’s most knowledgeable and innovative health care providers are clear. Incentives and accountability are misaligned. Detailed requirements are complex and return on investment is uncertain.

Unfortunately, based on the feedback we have from providers around the country, we conclude that the proposed ACO regulation will fail to accomplish its purpose. Therefore, we respectfully ask that you withdraw this proposed rule and re-engage experienced stakeholders to craft a new rule that fulfills the promise of ACOs.

In principle, the model of an ACO still holds promise. To truly improve the Medicare program for the beneficiaries of today and tomorrow, more ACO-like coordination and collaboration among providers and beneficiaries is undoubtedly a worthwhile goal. An ACO model that can increase provider coordination and patient accountability would be a step in the right direction compared with today’s fragmented delivery system. However, it is increasingly clear this proposed rule misses the target.

We look forward to the Department redesigning a regulation that will truly help accomplish our shared goals for patients, providers, and taxpayers alike: better care at lower costs. In the weeks ahead, we look forward to your working with you and other Administration leaders on this matter.


  • Tom Coburn, M.D. U.S. Senator, Oklahoma
  • Mike Crapo U.S. Senator, Idaho
  • John Cornyn U.S. Senator, Texas
  • Jon Kyl U.S. Senator, Arizona
  • Mike Enzi U.S. Senator, Wyoming
  • Pat Roberts U.S. Senator, Kansas
  • Richard Burr U.S. Senator, North Carolina

# # #


  *   *   *   *   *

RELATED: Abercrombie’s Medical Homes scheme rejected by Mayo Clinic, other top clinics

  *   *   *   *   *

RELATED:  CMS Releases Proposed Regulation on Accountable Care Organizations

The Centers for Medicare & Medicaid Services (CMS) has published a proposed regulation implementing Section 3022 of the Affordable Care Act (ACA). The ACA requires the HHS secretary to establish the Shared Savings Program by January 1, 2012. The program is intended to encourage providers of services and suppliers to create a new entity, which the statute terms Accountable Care Organizations (ACOs). Participating entities in an ACO would be charged with improving health and experience of care for individuals.

The new CMS rules provide guidance to provider organizations in setting up exchanges of healthcare data to improve care and reduce costs. According to the HHS website, HHS worked closely with other federal agencies to “ensure that providers and suppliers have the clear and practical guidance they need to form ACOs without running afoul of the fraud and abuse, antitrust, and tax laws.”

Consequently, the following notices also were released along with the publication of the ACO rules:

  • A joint CMS and OIG notice and solicitation of public comments on potential waivers of certain fraud and abuse laws in connection with the Medicare Shared Savings Program;
  • A joint FTC and DOJ proposed antitrust policy statement; and
  • An IRS notice requesting comments regarding the need for additional tax guidance for tax-exempt organizations, including tax-exempt hospitals, participating in the Medicare Shared Savings Program.

For more information, contact Thomas Phan.

  *   *   *   *   *



TEXT "follow HawaiiFreePress" to 40404

Register to Vote


808 Silent Majority

808 State Update AM940


ACA Signups Hawaii



Alliance Defending Freedom

Aloha Life Advocates

Aloha Pregnancy Care Center

American Council of Trustees and Alumni

American Mothers of Hawaii



Antonio Gramsci Reading List

A Place for Women in Waipio

Astronomy Hawaii

Audit The Rail

Ballotpedia Hawaii

Better Hawaii 

Blaisdell Memorial Project

Broken Trust 

Build More Hawaiian Homes Working Group

CAFR Hawaii

Castaway Conservative

Children's Alliance Hawaii

Children's Rights Institute

Christian Homeschoolers of Hawaii

Citizens for Recall

Cliff Slater's Second Opinion

Coffee Break

CSIS Pacific Forum

DAR Hawaii

DVids Hawaii

E Hana Kakou Kelii Akina

E Māua Ola i Moku o Keawe

Farmers For Choice Hawaii


Fix Oahu!

Follow the Money Hawaii

Frank in Hawaii

Front Page Magazine

Frontline: The Fixers

Genetic Literacy Project

Get Off Your Butts!

God, Freedom, America

Grassroot Institute

Hawaii Aganst Assisted Suicide

Hawaii Aquarium Fish Report

Hawaii Aviation Preservation Society

Hawaii Catholic TV

Hawaii Christian Coalition

Hawaii Cigar Association

Hawaii Coalition Against Legalized Gambling

Hawaii ConCon Info

Hawaii Credit Union Watch

Hawaii Crime Victims' Rights

Hawaii Crop Improvement Association

Hawaii Debt Clock

Hawaii Defending Marriage

Hawaii Defense Foundation

Hawaii Family Advocates

Hawaii Family Forum

Hawaii Farmers and Ranchers United

Hawaii Farmer's Daughter

Hawaii Federalist Society

Hawaii Federation of Republican Women

Hawaii Firearm Community

Hawaii Fishermen's Alliance

Hawaii Future Project

Hawaii Gathering of Eagles

Hawaii History Blog

Hawaii Homeschool Association

Hawaii Jihadi Trial

Hawaii March for Life

Hawaii Meth Project

Hawaii's Partnership for Appropriate & Compassionate Care

Hawaii Public Charter School Network

Hawaii Rifle Association

Hawaii Right to Life -- Big Island

Hawaii Right to Life -- Oahu

Hawaii Shield Law Coalition

Hawaii Shippers Council

Hawaii Smokers Alliance

Hawaii State Data Lab

Hawaii Together

Heritage Foundation

HI Coalition Against Legalized Gambling



Hiram Fong Papers

Homeschool Legal Defense Hawaii

Honolulu Homeless Crisis

Honolulu Navy League

Honolulu Traffic

Horns of Jericho Blog

House Minority Blog

House Republican Caucus YouTube


Hump Day Report

I Vote Hawaii

If Hawaii News

Imua TMT

Inouye-Kwock, NYT 1992

Inside the Nature Conservancy

Inverse Condemnation

Investigative Project on Terrorism

Iowa Meets Maui

Jackson v Abercrombie

Jihad Watch

July 4 in Hawaii

Kahle v New Hope

Kakaako Cares

Kau TEA Party

Kauai Co GOP

Keep Hawaii's Heroes


Land and Power in Hawaii

Legislative Committee Analysis Tool

Lessons in Firearm Education

Lingle Years

Malulani Foundation

Managed Care Matters -- Hawaii

Malama Pregnancy Center of Maui

Mauna Kea Recreational Users Group

Middle East Forum--The Legal Project

Mililani Conservatives for Change

Military Home Educators' Network Oahu

Missile Defense Advocacy

MIS Veterans Hawaii

Muslim Brotherhood in America

NAMI Hawaii


National Christian Foundation Hawaii

National Parents Org Hawaii

National Wind Watch

New Hawaiian

New Zeal

NFIB Hawaii News

No GMO Means No Aloha

Northwest Economic Policy Seminar

Not Dead Yet, Hawaii

Now What I Really Think

NRA-ILA Hawaii

Oahu Alternative Transport

ObamaCare Abortion Hawaii


OHA Lies

Opt Out Today

Pacific Aviation Museum

Patients Rights Council Hawaii

PEACE Hawaii

People vs Machine

Pritchett Cartoons 

Pro-GMO Hawaii


Rental by Owner Awareness Assn

Republican Party -- Hawaii State

Research Institute for Hawaii USA

Rick Hamada Show

RJ Rummel

Robotics Organizing Committee

Save Dillingham Airfield

School Choice in Hawaii

SIFE Remington

SIFE W. Oahu 

Sink the Jones Act

Smart About Marijuana--Hawaii

St Marianne Cope

State Budget Solutions Hawaii

State Policy Network

Statehood for Guam

Tax Foundation of Hawaii

The Harriet Tubman Agenda

The Long War Journal

The Real Hanabusa

Time Out Honolulu

Trustee Akina KWO Columns

Truth About Trade & Technology - Hawaii

UCC Truths

Union Members Know Your Rights

US Tax Foundation Hawaii Info

Valor in the Pacific

VAREP Honolulu

West Maui Taxpayers Association

What Natalie Thinks

Whole Life Hawaii