Hospitals and doctors are pushing back against an Obama administration initiative that urges them to create new organizations to coordinate the care of groups of Medicare patients.

The effort to create new health-care entities, called accountable-care organizations, stems from the health-care overhaul law. The idea is that the ACOs would be more efficient than many providers are today, with the resulting savings being shared by the providers in the ACOs and the federal government. At the end of March, regulators issued proposed rules governing how these organizations would be structured.

Some health-care providers say the broader ACO proposal is unworkable. A letter from 10 medical groups that participated in an earlier, similar Medicare demonstration project said it would be “difficult, if not impossible” to accept the financial design. The American Medical Group Association said a survey of its members found that 93% wouldn’t enroll as ACOs in the main proposed Medicare program.

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