by CQ HealthBeat | Mar 29, 2011

HHS is calling for nationwide implementation of accountable care organizations following the expected release of a proposed ACO rule this week, despite earlier indications that the agency would test ACOs through pilot programs first, CQ HealthBeat reports.

Details of ACOs, Proposed Rule

The federal health reform law requires the federal government to begin contracting with ACOs starting in January 2012 (Reichard, CQ HealthBeat, 3/28).

ACOs are intended to help hospitals and other providers coordinate and provide effective care.

Hospitals, physicians and insurance companies remain at odds over anticipated regulations. Their largest concerns involve competition and whether ACOs will be excluded from fraud and antitrust laws (California Healthline, 3/1).

A public comment period will follow publication of draft ACO regulations, the New York Times’ “Prescriptions” reports (Wilson, “Prescriptions,” New York Times, 3/28).

Implementing ACOs

Marilyn Tavenner, principal deputy administrator of CMS, told the Nashville Health Care Council last week that the proposed rule would focus on establishing pilot programs instead of a broad nationwide rollout.

However, Chris Stenrud, deputy assistant secretary for public affairs at HHS, on Monday said that “there is no scaling back” on the ACO launch. He said that pilot programs involving various innovative ACO models would “take place concurrently with broader ACO implementation.”

According to William Wynne of the lobbying firm Health Policy Source, HHS will move forward with a “shared savings” program in which ACOs that meet spending and quality improvement goals would split any savings with the federal government.

Meanwhile, HHS likely will issue a separate notice for health care providers “to pursue innovative ACO approaches that differ from the shared savings model outlined in the rule itself,” Wynne said (CQ HealthBeat, 3/28).