Nov 23 2010
The American Medical Group Association (AMGA), a professional association representing multispecialty medical groups and other organized systems of care, today released its comments on draft criteria for the credentialing of Accountable Care Organizations (ACOs) created by the National Committee for Quality Assurance (NCQA). AMGA fully supports ACOs and one of its top priorities is assuring their development and success.
"We were happy to provide comments to the NCQA," said Donald W. Fisher, Ph.D., CAE, AMGA's president and chief executive officer. "The work of its advisory panel, which developed the criteria, was thoughtful and thorough. While we agree with much of the NCQA framework, there are aspects of the framework that we believe need to be addressed. AMGA is concerned that creating several tiers of ACOs may dilute initial ACO efforts and limits their chances for success. If tiers are adopted, they should be limited to two levels: (1) Mature ACOs, which have the infrastructure necessary to be accountable for cost and quality and (2) Provisional ACOs, those that have substantially all of the capabilities and can reach maturity within three years."
In addition to the general remarks above, AMGA commented on several of the specific criteria in the document. AMGA recommended NCQA eliminate the provision requiring ACOs to carry stop-loss insurance/reinsurance. Such coverage primarily applies to insurance companies that assume risk, not potential ACOs. Such a requirement would apply to only a handful of potential ACOs and is premature at this point in ACO development.
AMGA also suggested that NCQA criteria for Patient Rights and Responsibilities comport with current federal laws and regulations in all cases. In addition, AMGA strongly supported those standards relating to Information Exchange for Care Coordination and Transitions and Population Health Management, among others.
To view the complete content of AMGA's comments to NCQA, please visit the AMGA Web site at www.amga.org.
Source: The American Medical Group Association