ACOs and the Law: An Evolving Issue

One of a series of reports on the October 21 MMS forum, “Toward a Shared Vision of Payment Reform.”

Sara Rosenbaum, JDAn expert on health care law told attendees at an MMS forum on payment reform that the legal parameters for accountable care organizations are in transition, and that will probably change over the years.

Sara Rosenbaum, JD, chair of Department of Health Policy at the George Washington University school of Public Health and Health Services, reviewed the basics of how anti-trust law treats physician practices, and discussed the kind of integration that the law currently accepts. The key decision, she said, occurred in a 1982 case in Arizona, when the physicians of Maricopa County Medical Society were found to be colluding on prices.

But she said that today, when health policy is encouraging broad integration of the health care delivery system, there’s a strong tension between the objective of anti-trust law to promote competition, and new health care policy.

However, she said the potential benefits of such collaboration are so compelling that “the anti-trust imperative will in time give way to the integration imperative, because you cannot deliver these kind of results with that kind of integration.”

This forum was co-sponsored by the Massachusetts Medical Society and the Commonwealth Fund.

Video excerpts of Ms. Rosenbaum’s presentation:

Download her slide presentation. (.pdf, 10 pages)

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