The Centers for Medicare & Medicaid have issued the final rule for Accountable Care Organizations (ACO). The final rules have been well received by many provider groups and offer some marked changes from the proposed rules, initially released in March.
Created through provisions in the Affordable Care Act, ACOs are networks of doctors and hospitals that share responsibility for providing care for patients. Although many providers supported the idea of ACOs, doctors and other healthcare providers overwhelming disapproved of the initial proposed rules. The final rules included some major changes that addressed some of these groups’ objections. “We feel we have struck a better balance between creating a strong business case for providers to want to participate in the ACO framework and, in the same time, not taking away patient protections,” said Jonathan Blum, deputy administrator of CMS, about the new rules.
The final rules no longer require that all ACOs risk losing money. Providers can choose to participate in an ACO and share in Medicare savings without risk or take on more risk for the chance to earn larger savings. The final rules also reduced the number of quality measures from 65, a number that many providers called redundant and costly, to 33. Another major change was the inclusion of community health centers and rural health clinics. The final rules allow these providers to lead ACOs, a process that would have been difficult under the previously proposed rules. Allowing groups to apply throughout 2012, CMS has also given providers more time to prepare for the launch of ACOs. The initial response to these changes has generally been favorable, but with the vast amount of information being released, organizations will likely take weeks to synthesize all the aspects of these new rules.
Read a chart summarizing the major differences between the proposed and final rules for ACOs and learn more about the many aspects of Accountable Care Organizations.
ALFA will be discussing some of the opportunities and uncertainties surrounding ACOs next week at the ALFA 2011 Senior Living Leadership Forum. The invitation only event promises to provide some insight into the market dynamics that will affect the future of Accountable Care Organizations.
Suggested Articles:
