HHS Releases Proposed Rules Governing Accountable Care Organizations

 

HHS Releases Proposed Rules Governing Accountable Care Organizations

Thursday, March 31st, 2011 - 12:05
Thursday, March 31, 2011 - 11:50
The administration has released proposed rules governing accountable care organizations, which it says will save between $500 million and $960 million in the beginning.

The Department of Health and Human Services this morning released hundreds of pages in rules governing accountable care organizations (ACOs), which are networks of health providers who will be judged on their ability to meet health performance measures.

National Journal reports that the administration believes the ACOs will save between $500 million and $960 million in Medicare payments at the beginning. Kaiser Health News reports that officials will evaluate potential ACO formations within 90 days to quickly determine whether the arrangement would run afould of antitrust laws.  Patients will not join the ACOs as individuals, their doctors will, the outlets report. Patients will be informed that they are being treated within an ACO, and will not lose any of their current options.

Backers of health reform have high hopes for ACOs, which will strive to better coordinate care within a network of doctors and hospitals. The network will be given a certain amount of money to care for a patient, and will receive bonuses based on its ability to meet health performance targets. The goal is to end the practice of fee-for-service, uncoordinated care, which is among the main drivers of health cost inflation.

However, many have raised concerns that the networks could perversely use their market power to behave as monopolists and drive up the cost of care. Determinations about whether an ACO will run afoul of antitrust laws will be crucial.