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HHS outlines changes to health law's ACO regulation
Federal regulators on Thursday unveiled the rules controlling the health law's principal tool for making the nation's healthcare system more efficient.
The Obama administration estimates that Accountable Care Organizations could save the government up to $940 million from 2012 through 2015 ($470 million is more likely). The program seeks to reward health systems that improve patient care through better coordination between physicians, hospitals and other healthcare providers; anywhere from 1 million to 5 million Medicare beneficiaries are expected to get care through 100 to 200 ACOs.
Preliminary ACO regulations issued in April received a torrent of criticism from health systems that said the rules were too burdensome and contained too few incentives. The final rule released Thursday claims to "have made significant modifications to reduce burden and cost for participating ACOs."
• Greater flexibility in eligibility to participate in the Shared Savings Program;
• Multiple start dates in 2012;
• Establishment of a longer agreement period for those starting in 2012;
• Greater flexibility in the governance and legal structure of an ACO;
• Simpler and more streamlined quality performance standards;
• Adjustments to the financial model to increase financial incentives to participate;
• Increased sharing caps;
• No downside risk and first-dollar sharing in Track 1;
• Removal of the 25 percent withholding of shared savings;
• Greater flexibility in timing for the evaluation of sharing savings (claims run-out reduced to three months);
• Greater flexibility in antitrust review;
• Greater flexibility in timing for repayment of losses; and
• Additional options for participation of Federally Qualified Health Centers and Rural Health Clinics.
Healthwatch will be updating this story as more details and reactions trickle in throughout the day, so please stay tuned.
