March 31, 2011

CMS Proposes Rules for New ACOs

On March 31, 2011, the Centers for Medicare & Medicaid Services (CMS) proposed much-anticipated rules under the Patient Protection and Affordable Care Act (PPACA) to regulate new Accountable Care Organizations (ACOs).  According to CMS, ACOs are groups of health care providers that “work together to treat an individual patient across care settings, including doctor’s offices, hospitals, and long-term care facilities.”

CMS asserts that ACOs will provide better, more efficient care for patients while simultaneously saving hundreds of millions of dollars for the Medicare system.  The notion is that the various health care providers within an ACO will be able to better coordinate a patient’s care, treatments and conditions as he or she seeks care from one organized provider to another.  At the same time, ACOs incentivize providers by rewarding those that are able to lower health care costs and maintain quality of care standards.   Though provider and patient participation in an ACO will be voluntary, an ACO that wants to participate must first register with CMS.

Once instituted, ACOs will have wide-ranging implications for Medicare beneficiaries, health care providers and even law enforcement.

This post was contributed by Aaron S. Mensh.