Accountable Care Organizations: Final Rule Announced

Accountable Care Organizations, a key element of the health care law designed to control costs while providing quality care to Medicare recipients, got an important shot in the arm earlier this month when the Centers for Medicare & Medicaid Services issued its final regulations for implementing the ACO Shared Savings Program. We’ll continue to update you on this development as commentary and analysis comes in: 

CMS expects ACOs will transform – not just improve – the delivery and coordination of health care:

“In its announcement of the final rule, the government highlighted that ACOs represent a major step forward for transforming Medicare and Medicaid to help assure high quality and seamless health care for continuous improvement. The government defines ‘seamless and coordinated care’ in reference to what patients want.” (From The ACO Final Rule Is Released Are You Ready by Poyner Spruill LLP) 

Industry interest in ACOs is significant:

“Based on comments it received to the proposed rule, CMS continued to expand the list of eligible ACO participants beyond the statutory mandate and those entities identified in the proposed rule. This expansion allows for further innovation in possible ACO models and encourages movement away from the current fee-for-service model with the addition of shared savings incentives. CMS continues to stand by this open approach despite concerns that the inclusion of other providers would not produce the efficiencies CMS was attempting to incentivize providers to create.” (From CMS Provides Final Framework for ACO and Shared Savings Program Rules: ACO Participants Get Greater Flexibility by Ober|Kaler) 

Time is of the essence:

“For the as many as 6,000 groups that, reportedly, have already notified CMS of their intention to submit an application for approval of some form of ACO or other shared savings program (SSP), it is ‘off to the races. A quick pace is important because, under the final rule, in order to qualify to enter the April 1 or July 1, 2012 start date, applicants must have developed their programs by January 1, 2012, and qualifying applications will be due soon thereafter.” (From The Affordable Care Act and Accountable Care Organizations Final Regulations Released by Akerman Senterfitt) 


See Also

Final Antitrust Policy Statement Regarding ACOs in Medicare Shared Savings Program (Duane Morris LLP) 


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