After months of review, the federal government finalized the rules for accountable care organizations, set to begin formation in 2012.
The Accountable Care Organization initiative aims to shift the business of health care delivery from a fee-for-service model to one that pays hospitals and care providers based on quality of care, coordination of care and cost-effectiveness. It’s slated to kick off on a voluntary basis next year.
Medicare officials reviewed more than 1,300 comments on the preliminary rules released in spring, and announced their decisions yesterday.
Through ACOs, care providers can continue to participate in Medicare reimbursements, but may also win rewards for saving money for the program by working together to cut down on duplicate tests and medical errors.
The program has been praised by industry, with some words of warning.
In an opinion piece published on the Health Affairs blog earlier this year, AdvaMed president and CEO Stephen Ubl wrote that the ACO program "is the right treatment to fix the ills of our nation’s health system," but cautioned that it runs a "real danger of stinting on care" for Medicare patients.
Ubl added that the program needs "protections to ensure appropriate care for individual patients," namely an independent oversight board to prevent "arbitrary ‘stinting’" from rationing care for individual patients.
The final ACO rules include improvements suggested by comments collected during the last few months, Medicare chief Donald Berwick said in a press release.
Changes from the original concept include extending participation to rural health clinics and organizations where specialists provide primary care, as well as providing a flexible starting date in 2012.
