Health Information Management

News: CMS releases final rule governing ACOs

CDI Strategies, November 10, 2011

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On October 20, CMS released its long-awaited final rule governing accountable care organizations (ACO), with major concessions to the original plan that had soured many healthcare leaders and physicians against participating.

 The 696-page document, 267 pages longer than the proposed rule, includes more generous shared savings incentives, omits 32 of the 65 original quality measures, and gives ACO candidates more time to get started.
A critical change is that the rule no longer requires 50% of participating physicians to have achieved meaningful use requirements for electronic health record use.
Compared with the proposed rule, there are many more opportunities for new ACOs to participate without absorbing risk in the early years of the program.
Significantly, each ACO will now know prospectively, as opposed to retrospectively, who their included beneficiaries are, and will be able to contact them in advance. As before, beneficiaries will be able to opt out of the program as well as seek care outside of the ACO.
Editor’s Note: This article was adapted from HealthLeaders Media.

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