With the advent of this year, the formation of Accountable Care Organizations (ACOs) has stirred up interests of many in healthcare administration. Accountable Care Organizations (ACOs)are defined as ‘a set of providers associated with a defined population of patients, accountable for the quality and cost of care delivered to that population’. The ACO has significant priority for clinicians since they must comply with this voluntary accountability to secure performance based incentives and be penalized in the case of malpractice.
To construct this accountability system, CMS’s Final Ruleoutlines several ACO programs, modifications and timelines. The ACO programs offered are:
CMS is anticipating that these ACOs will evolve into sustainable systems over the coming months, evaluating performance and playing important role in balancing healthcare costs. The program would serve as a platform to show off public-private partnerships that fine-tune the healthcare system and show improvement through internal checks and reward pay outs.
The registration period for ACO’s to apply to CMS commenced on January 1, 2012. ACOs who apply now would enter into an agreement from April 01, 2012 for a first performance year of 18 or 21 months. Beneficiaries from the registered ACO have to report on 33 quality measures in order to qualify for the first-performance year shared savings.
Although, ambiguity and speculations surround the overall design, organizational infrastructure and effectiveness of ACOs, the government seems steadfast in making healthcare practitioners and organizations, mutually responsible for the betterment of the healthcare system.
There are many models that can be followed to structure an ACO, existing health delivery consortiums can also be replicated e.g.
(Source article S.M. Shortell, L.P. Casalino, and E.S. Fisher, “How the Center for Medicare and Medicaid Innovation Should Test Accountable Care Organizations,”)
From any of aforementioned suggested models, healthcare providers may follow one and form an ACO.