CMS Proposed Rule on Accountable Care Organizations
April 2011
Proposed rule from the Centers for Medicare and Medicaid Services on Accountable Care Organizations or ACOs. The proposed rule defines an ACO as a "legal entity that is recognized and authorized under applicable State law, as identified by a Taxpayer Identification Number (TIN), and comprised of an eligible group (as discussed in section II.B. of this proposed rule) of ACO participants that work together to manage and coordinate care for Medicare FFS beneficiaries and have established a mechanism for shared governance that provides all ACO participants with an appropriate proportionate control over the ACO's decision making process."
According to the Department of Health and Human Services press release, ACOs "create incentives for health care providers to work together to treat an individual patient across care settings – including doctor’s offices, hospitals, and long-term care facilities. The Medicare Shared Savings Program will reward ACOs that lower health care costs while meeting performance standards on quality of care... Patient and provider participation in an ACO is purely voluntary." A fact sheet on ACOs is also available.
Fact sheet on ACOs for providers .
Fact sheet on ACOs for consumers .
Fact sheet on legal issues and ACOs
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Fact sheet on quality scoring in ACOs
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FTC and DOJ Proposed Antitrust Enforcement Policy Statement Regarding Accountable Care Organizations Participating in the Medicare.
Notice from the IRS on how a non-profit's tax-exempt status could be affected by participation in an ACO.
CMS Proposed Rule on Accountable Care Organizations