ACO Sample Letter
AANP, January, 2013
The Honorable ________________
Dear Representative/Senator ____________________
I am writing to express my concern regarding the published rule for the Medicare Primary Care Accountable Care Organizations regarding the barring of nurse practitioner patients from assignment to Medicare Primary Care Accountable Care Organizations. This limitation will significantly impair the ability of patients in our practices to access primary care services. In addition it will negatively affect not only access, but the cost and quality of the care provided by the ACOs.
Nurse practitioners have a long history of providing high quality, cost effective care. As such we can be assets to the ACOs in the areas of quality and cost savings. The required quality indicators that have been identified are within the scope of the nurse practitioner’s practice. Our skills in the area of care coordination, chronic disease management, health promotion and disease prevention would contribute significantly to the quality and cost savings of any shared saving program. I, therefore, ask that you examine the statute and published rule and find a way for nurse practitioners to join ACOs as full participants, as was originally intended so that the patients of nurse practitioners be able to be assigned to ACOs.
(Suggested Personal Comments for NPs in Own Practices)
In my practice patients have chosen me as their primary care provider and I am responsible for managing their primary care needs. Contact with a physician is through referral and based on patient care needs. Other members of the health care team are also utilized based on patient needs. Requiring even one visit by a physician each year will not work in this environment.
(Suggested Personal Comments for NPs in Physician Practices)
In my practice patients choose their primary care provider who is then responsible for managing their primary care needs. In my practice, contact with the physician is random and serves as a backup for me when I am not available. Other members of the health care team are utilized based on patient need. Requiring a certain percentage or even one visit by a physician each year is counterproductive. It adds cost for additional visits, interferes with continuity of care and would waste the time of the patient as well as the physician who is trying to comply with the rules of the ACO.
Please help to have this proposal and its related statute reexamined and changes made so that I may fully participate and my patients may be an assigned beneficiary in a primary care ACO.
*You may wish to add your personal experiences to this letter.
Senators: The Honorable __________
United States Senate
Washington, DC 20510
Representatives: The Honorable __________
United States House of Representatives
Washington, DC 20515