Medicare needs to change accountable care organization (ACO) rules set up to prevent ACOs from avoiding the sickest patients to allow the groups to better manage patients with chronic illnesses, says Sen. Ron Wyden, D-Ore.
 
The “attribution rule” requires ACOs to treat everyone who comes through the door, Wyden said in remarks at the National Accountable Care Organization Summit. It’s set up so providers can’t “shed risk and avoid the sickest patients,” he said. But it limits ACOs that want to specialize in chronic care.
 
About 70% of Medicare patients have two or more chronic conditions that account for more than 90% of Medicare spending – almost $500 billion a year, Wyden said.
 
The attribution rule doesn’t stop ACOs from working to manage chronic illnesses, as Part B News readers know. For example, ACO Crystal Run Healthcare in Middletown, N.Y., reduced by 9% its cost of care for diabetics while maintaining or improving quality.
 
Stay tuned to Part B News to keep tabs on whether Wyden has success implementing his ACO changes.