In late April, the Department of Health and Human Services released the much anticipated details on Accountable Care Organizations (ACOs). In particular, the proposed regulations spell out the Medicare Shared Savings program.
For those new to the topic, an ACO is a component of the Patient Protection and Affordable Care Act of 2010 and defined as an integrated health care delivery system that relies on primary care physicians, hospital(s), and subspecialists to provide care to a defined patient population. Under the model, hospital and physician networks are responsible for the care delivered to patients and incentivized to work together to treat Medicaid patients across care settings to lower growth in costs while meeting performance standards on quality of care (note: a pediatric ACO demonstration project is also included for Medicaid patients, to begin in January 1, 2012). A recent Wall Street Journal article nicely summed up some pros and cons of an ACO.