CMS Delivers Final ACO Rules

Via Modern Healthcare

Final rules for Medicare’s accountable care organizations, released today by the CMS, made significant changes to proposals widely rejected by hospitals and physician groups.

Accountable care under Medicare offers financial incentives to providers that achieve quality and cost-saving targets. The Patient Protection and Affordable Care Act calls for Medicare to offer accountable-care agreements starting in 2012. The agency released draft rules in March for three-year agreements that providers sharply criticized as too risky and burdensome. More than 1,200 comments were submitted, according to CMS.

Final rules reduced quality measures to 33 (PDF) from the 65 originally proposed. CMS officials said in regulations released today the agency sought to reduce the administrative burden and eliminate potentially redundant measures. CMS also eliminated a potential penalty for the final year under one of two proposed accountable-care payment models. Previously, one payment proposal required ACOs to accept risk during the last year of a three-year agreement. The other model requires ACOs to accept risk for all three years.


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