Rural Physicians and ACOs

Resolved Section(s):
RESOLVED: That our AMA work with CMS to include rural physicians, caring for over 51 million Americans, in programs such as Accountable Care Organizations; and be it further RESOLVED: That our AMA make sure that there are adequate provisions in Accountable Care Organization programs and arrangements to protect the interests of rural physicians.RATIONALE: Due to the fact that the American Medical Association (AMA) already has a provision pertaining to rural physicians and accountable care organizations (ACOs) in its Accountable Care Organization Principles document, the Committee elected to recommend no action on this resolution. The AMA provision is as follows:“Additional resources should be provided up front in order to encourage ACO development. CMS’s Center for Medicare and Medicaid Innovation (CMI) should provide grants to physicians in order to finance up-front costs of creating an ACO. ACO incentives must be aligned with the physician or physician group’s risks (e.g., start-up costs, systems investments, culture changes, and financial uncertainty). Developing this capacity for physicians practicing in rural communities in solo-small group practices requires time and resources and the outcome is unknown. Providing additional resources for the up-front costs will encourage the development of ACOs since the “shared savings” model only provides for potential savings at the back-end, which may discourage the creation of ACOs (particularly