This is the third in our client advisory series on accountable care organizations (ACOs). CMS published the final ACO regulations in the Federal Register on Nov. 2, 2011. One of the primary components of the rules is the quality standards by which CMS plans to evaluate the performance of ACOs. That performance will be a key part of the formula used to share savings (or losses) between CMS and each ACO.

Quality Measures Reduced by Half

Comments received by CMS to the proposed regulations resulted in significant changes, both large and small. Big changes include CMS’s decision to reduce quality measures almost exactly in half, from 65 to 33. Those 33 measures are grouped into four “domains,” which are used as intermediate steps in calculating an ACO’s quality score. The four domains are:

• Patient experience

• Care coordination and safety

• Preventive health

• At-risk populations