Health Information Management

News: CMS releases final rule governing ACOs

CDI Strategies, November 10, 2011

Want to receive articles like this one in your inbox? Subscribe to CDI Strategies!

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.



Want to receive articles like this one in your inbox? Subscribe to CDI Strategies!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular