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Draft ACO Rules – Summary and Analysis

On March 31, 2011, the U.S. Department of Health and Human Services released these proposed rules that will, when final, facilitate the operation of Accountable Care Organizations (ACOs) under the ACA.

I, along with my ITUP colleagues Sara Watson and Erica Brode, just produced this brief report that
(a) provides a summary of the proposed ACO regulations,
(b) outlines relevant criticisms of the draft rules, and
(c) offers assessment of those critiques.

The proposed rules offer a glimpse into CMS’s plans for the design and regulation of ACOs under the Medicare Shared Savings Program (MSSP). The rules address:

  • Structure & Size
  • Quality
  • Evidence-Based Medicine
  • Health Information Technology
  • Beneficiary Assignment
  • Savings
  • Administration & Governance
  • Transparency & Sharing Data

Since the release of the long-awaited proposed regulations, various stakeholders and observers have offered considerable pushback and specific criticisms of the rules. Our paper summarizes and assesses some of the most vocal and substantive critiques. Many have minor suggestions to better the rules, while others argue that unless the rule is drastically changed, organizations will not apply to become ACOs and we will have missed huge opportunities to bend the cost curve.

We hope you find this analysis helpful to your work.