Accountable Care Organizations: An Opportunity Deserving Consideration?

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The 2010 Patient Protection and Affordable Care Act (2010 Reform Act) established a voluntary Medicare Shared Savings Program (Program). On March 31, 2011 the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to implement the Program. To participate in the Program, groups of eligible Medicare providers and suppliers must form an Accountable Care Organization (ACO) approved by CMS. The proposed rule describes the goals of the Program, the requirements for ACOs and the incentive for participation – the opportunity for an ACO to receive a shared savings payment measured against an expenditure benchmark.

Comments on the proposed rule were due by June 6, 2011. Following consideration of comments, CMS will issue a final rule and commence processing applications submitted by organizations seeking to be approved as an ACO. The start date for initial three year contracts between CMS and ACOs is anticipated to be July 1, 2012.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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