ACO Rule: Can You Qualify and Do You Want To?
On the last day of March 2011, CMS issued proposed rules for implementing the "Shared Savings" program, introduced in the 2010 health reform act.
This program, due to start in 2012, awards provider networks called Accountable Care Organizations (ACOs) a portion of savings generated from more efficient care of assigned fee for service Medicare patients.
The highly anticipated rules are set out in more than 400 pages, and outline the requirements to qualify and obtain approval as an ACO, ongoing standards that these organizations will need to meet and the manner in which savings will be calculated and paid.
Medicare intends that both small and regional entities will qualify.
However, the number of required attributes and functions of ACOs may dissuade smaller groups to participate, and they may not have the economies of scale necessary to achieve significant dollar savings.
On the other hand, ACO participation may become critical for providers to reverse decreasing Medicare fee for service revenue. Join healthcare attorney, Wayne J. Miller Esq., for this 60-minute look at ACOs and what they mean to you.
Take a look at what’s covered:
- Types of provider entities that automatically qualify
- Can management companies or other laypersons be part of an ACO?
- How does an entity get approved and what are the requirements?
- How Medicare patients are assigned to ACOs
- Will antitrust, fraud and abuse and Stark laws be waived?
- Getting enrollees and keeping them: what’s allowed and what isn’t
- Can you earn a bonus? Calculating the benchmark and savings.
Who should attend? Hospital, clinics, practice managers, physicians, medical groups, and health care consultants.
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