Last Thursday the Centers for Medicare and Medicaid Services (CMS) released the much-anticipated Shared Savings Program proposed rule, intended to encourage the development of Accountable Care Organizations (ACOs) as provided for in Section 1899 of the Affordable Care Act. The Affordable Care Act (ACA) requires the US Department of Health and Human Services (HHS) to establish the Shared Savings Program by January 1, 2012 to promote accountability for patient populations, coordinate services under Medicare Parts A and B, encourage investment in infrastructure, and improve the quality and efficiency of health care services.
The proposed rule will be published in the Federal Register on April 7 and is available at: http://www.ofr.gov/OFRUpload/OFRData/2011-07880_PI.pdf. CMS will accept public comments through June 6, 2011.
There will be much to comment upon and CMS is expressly soliciting comments in a number of different areas. Of particular note is their desire to require ACOs to accept risk if costs for care run over the benchmark. The stakes are high for participating providers who must make a three-year commitment in a program that preserves the freedom of patients to obtain services from health care providers outside of an ACO and proposes to withhold 25 percent of any shared savings until after the three-year agreement term ends.
To read a detailed description and analysis of the Shared Savings Program and ACOs, please click here.
The Arent Fox Health Care Practice Group has organized an ACO Task Force that will be closely following the development and implementation of the rule.