ACCOUNTABLE CARE ORGANIZATION (ACO) EFFORTS RAMP UP:
On February 11, eight Democratic Senators sent a letter to the Department of Justice (DOJ) and the Federal Trade Commission (FTC), asking the two entities to work together on antitrust guidance for the Accountable Care Organizations (ACOs) that will soon be created under the new healthcare law, the Patient Protection and Affordable Care Act (PPACA).
ACOs will facilitate coordination and cooperation among providers to improve the quality of care for Medicare beneficiaries and reduce unnecessary costs – one of the many PPACA delivery system reforms that seeks to better the system through incentives to enhance quality, improve beneficiary outcomes and increase value of care. ACOs that meet soon-to-be-determined quality standards will share in any cost savings that are achieved though the efficient delivery of care.
In their letter to the DOJ and FTC, the Senators noted the considerable expertise that both entities have developed in healthcare antitrust matters, and expressed concern that allowing antitrust jurisdiction for ACOs to be placed solely with the DOJ or FTC “…will not fully harness the aggregate expertise and experience necessary to make ACOs work.”
The next business day, the Centers for Medicare and Medicaid Services (CMS) sent its proposed rule for the establishment of ACOs to the Office of Management and Budget (OMB) for review – the final step before the long-awaited proposed rule will appear in the Federal Register.
Though the proposed rule was originally expected to be issued last month, CMS stated that it still expects to have the program in place by January 1, 2012, while also following “all the notices and processes” of the rulemaking cycle. The rule is expected to be released this week.