HHS releases proposed ACO regulations

By Diana Manos
11:38 AM

WASHINGTON – The Department of Health and Human Services’ proposed regulations on accountable care organizations, released March 31, will be one of the first delivery-reform initiatives to be implemented under the Accountable Care Act and will be key to overhauling the U.S. healthcare system, said Donald Berwick, MD, administrator of the Centers for Medicare & Medicaid Services.
In a March 31 article published in the New England Journal of Medicine, Berwick said ACOs will be designed to accelerate progress toward better care for individuals and populations and slow growth in costs through improvements in care.
The proposed ACO regulation does not specify how much providers will earn participating in the voluntary program. HHS is taking comments on the proposal until June 6.
According to the proposal, ACOs would have to meet quality standards in five key areas – patient/caregiver care experiences; care coordination; patient safety; preventive health; and at-risk population/frail elderly health.
"The proposed rule includes strong protections to ensure patients do not have their care choices limited by an ACO," said HHS Secretary Kathleen Sebelius.
William F. Jessee, MD, president and CEO of the Medical Group Management Association, said, "The formation of ACOs has the potential to greatly improve the coordination of care received by Medicare beneficiaries, and offers the promise of safer, more efficient and effective care.”
The American Medical Group Association will be reviewing the proposed rule to see how it aligns with the AMGA's ACO principles for physician-led entities, team-based infrastructures and patient-centric care, said Chet Speed, the AMGA’s vice president of public policy. "AMGA fully supports the ACO concept and looks forward to working with CMS on this delivery system innovation," Speed said.
The proposal calls for the group practice reporting option, an electronic reporting tool already used by the government in the physician quality reporting system, to be updated for ACO use. How well certified EHRs interface with the GPRO will be critical, said Brian Ahier, of the Mid-Columbia Medical Center in Dalles, Ore. "This poses a real business opportunity for EHR vendors," he said.
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