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Medical group pans key element of Obama health care plan

Says regulations so complex they are not workable

By Ricardo Alonso-Zaldivar
Associated Press / May 12, 2011

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WASHINGTON — President Obama’s main idea for getting quality health care at less cost was in jeopardy after key medical providers yesterday called his administration’s initial blueprint so complex it is unworkable.

Just over a month ago, top officials released long-awaited draft regulations for “accountable care organizations,’’ networks of doctors and hospitals that would collaborate to keep Medicare patients healthier and share in the savings with taxpayers. Obama’s health care overhaul law envisioned quickly setting up hundreds of such networks around the county to lead a bottom-up reform of America’s bloated health care system.

But in an unusual rebuke, an umbrella group representing premier organizations such as the Mayo Clinic wrote the administration, saying that more than 90 percent of its members would not participate, because the rules as written are so onerous it would be nearly impossible for them to succeed.

“It’s not just a simple tweak, it’s a significant change that needs to be made,’’ said Donald Fisher, president of the American Medical Group Association, which represents nearly 400 large medical groups around the country providing care for roughly 1 in 3 Americans.

Its members, including the Cleveland Clinic, Intermountain Healthcare in Utah, and Geisinger Health System in Pennsylvania, had been seen as the vanguard for accountable care.

The medical groups say they are worried they will be hit with losses, that the government has designed the system so there is no easy way to tell which patients are part of the program, and that there is no reliable way to adjust for patients who are sicker and require closer follow-up and more expensive treatments.

The deadline for public comments on the proposed regulations is still weeks away, but Fisher said “we needed to get their attention early on, so [the administration] could be thinking about how major changes are needed to make these regulations viable.’’

Many in the health care industry were silent partners backing Obama’s overhaul law, but disappointment over the accountable care rules has put a chill into the relationship.

During the congressional debate, Obama extolled Mayo and Geisinger, holding them up as a model of what he wanted to achieve for the nation.

Industry criticism of his administration’s proposal has been building up for weeks in online forums.

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