CMS releases final ACO rules

The Centers for Medicare and Medicaid Services has released final rules for Accountable Care Organizations, which have been modified from the proposed rules based on public comments, according to a press release from CMS. 

According to the press release, CMS received over 1300 comments on the proposed ACO rules, released in March, and has incorporated many into the final rules. 

Changes between the proposed rules and final rules include:

  • Providers will now be able to participate in an ACO and share savings with Medicare without risk of losing money.
  • CMS has reduced the number of quality measures that ACOs will have to meet in order to qualify for performance bonuses.  ACOs will now have to meet 33 quality measures in 4 domains, down from 65 metrics across 5 domains.
  • The ACOs will also be told which patients are likely to be part of their system. Under the proposed rule, ACOs would not know which patients were in the ACO until their contract ended.
  • CMS has revised the timetable for applying for ACO status, now allowing providers to apply through 2012.
  • CMS has removed the requirement for 50% of primary care physicians to be using electronic health records as defined by the meaningful use criteria; however, the EHR use quality metric is weighted double the amount of other quality metrics.

A full list of changes between the proposed rules and final rules can be viewed here.

(Sources: Kaiser Health News, http://www.kaiserhealthnews.org, October 20, 2011; The Advisory Board Daily Briefing, http://advisory.com, October 20, 2011; Centers for Medicare and Medicaid Services, https://www.cms.gov, October 20, 2011)