ACO Final Rule On Its Way

CMS has sent the Medicare Shared Savings Program regulations to the Office of Management and Budget, one of the last stops prior to being published in the Federal Register.  The Medicare Shared Savings Program will govern the administration of Accountable Care Organizations (“ACOs”). The proposed rules, issued in March, contained 127 pages of details and 65 measures related to the formation of an ACO.  Based on the backlash from industry leaders, it is expected that the final rule will contain significant changes.

Impact of “Big Data” in Health Care

A Recent report from McKinsey & Company on the evolution of information technology focuses on health care as a sector to watch: “For instance, if US health care could use big data creatively and effectively to drive efficiency and quality, we estimate that the potential value from data in the sector could be more than $300 billion in value every year, two-thirds of which would be in the form of reducing national health care expenditures by about 8 percent.” Full report at

CMS Releases Proposed Rules for Accountable Care Organizations

On March 31, 2011, CMS released its proposed rules for public review and comment relating to Medicare payments for health care providers participating in Accountable Care Organizations (ACOs).  Under the proposed rules, health care providers participating in ACOs would be eligible to receive additional Medicare payments based on meeting certain specified quality and savings requirements in addition to receiving traditional Medicare fee-for-service payments under Medicare Parts A and B.

The proposed rules are available here and will be published in the Federal Register on April 7, 2011.  A fact sheet published by CMS which provides a summary of proposed rules is available here.  If you would like further information about ACOs, please contact Dave Schoolcraft or Elana Zana.