Medicare accountable care organization rules raise questions

April 25, 2011

Medical groups raised questions about structure and revenue-sharing after the Centers for Medicare and Medicaid Services unveiled its proposed rule about accountable care organizations.

Medical groups raised questions about structure and revenue-sharing after the Centers for Medicare and Medicaid Services (CMS) unveiled its proposed rule about accountable care organizations (ACOs).

"We're pleased by the requirement for physician leadership," says Roland Goertz, MD, president of the American Academy of Family Physicians, "but there's no direction in there about the shared savings."

Under the proposed rule, an ACO, which could be comprised of physician practices, hospitals, or both, would enter into an agreement with CMS to take responsibility for improving quality and coordination of care for a group of at least 5,000 beneficiaries. The proposed rule, released in late March, includes 65 quality measures focusing on patient satisfaction, processes, and health improvements.

x