The Centers for Medicare and Medicaid Services (CMS) recently released the final rules for accountable care organizations (ACO) in an effort to help prepare healthcare providers who wish to make the transition.
While the final rules are intended to make participation in ACOs and the Shared Savings program easier for physicians, many healthcare providers are still wary of the new system as they are inundated with changing healthcare requirements.
The CMS announced new rules that establish waivers to remove certain barriers to ACO participation for many providers, as well as the Advanced Payment model that allows physician-owned and rural providers who participate in the Shared Savings program to access their benefits upfront.
Healthcare providers who receive their shared savings upfront could offset some of the initial infrastructures, IT, and staffing investments to minimize risk and spread the cost out over time.
With HIPAA 5010, ICD-10, Meaningful Use, and other healthcare reforms eating into a physician’s day simplified ACO rules are essential if the CMS hopes for even moderate adoption.
Here’s how the CMS hopes to make accountable care organizations more physician-friendly:
Final ACO Rules
The number of quality performance reporting measures has been cut in half – from 65 to 33 quality performance measures – significantly reducing the reporting burden.
The 50 percent threshold for physicians to achieve meaningful use of electronic health records was dropped.
Rural and federally qualified health centers have been added for ACO participation.
CMS will cover the cost of the required patient satisfaction surveys administered by the Consumer Assessment of Healthcare Providers and Systems for the first two years of the program.
Providers get increased flexibility in the start date of ACOs. In addition to January 1, 2012, April 1 or July 1 start dates will also be accepted by the CMS. ACOs starting later in 2012 will still have agreements through the end of 2015 and allow for a “first performance year” that ends the final month of 2013 with a range of 18 to 21 months.
The Affordable Care Act requires an ACO have at least 5,000 Medicare fee-for-service beneficiaries assigned to it. However, the final rules use an “expanded methodology” to make it easier for ACOs in smaller and rural markets to meet the threshold.
Do these new rules make ACOs more appealing to your practice? Tell us why or why not.
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