Encouraged Under Health Law, Plans Drawn For Accountable Care Organizations

CQ HealthBeat: Accountable Care Organizations were "given a boost" under the health care law "but they must be carefully structured to get the job done, the Medicare Payment Advisory Commission said Monday. The commission said in a letter to the Centers for Medicare and Medicaid Services (CMS) that in order to work, ACOs can't simply be given bonus payments if they meet goals for controlling costs and improving quality. They must also pay for some of the overruns if they exceed the spending target they are given. The letter adds that ACOs could also help Medicare patients 'receive more coordinated care and become more engaged with their care management, particularly if beneficiaries are informed when they are assigned to ACOs'" (Reichard, 11/22).

Knoxville News Sentinel: "The health reform law encourages accountable care organizations, or ACOs, as a way to improve the quality of care for Medicare beneficiaries and reduce unnecessary costs. ACOs expand the concept of a patient-centered medical home to include not only a primary care practice but hospitals, specialists and other health care professionals who are ultimately held accountable for the cost and quality of care delivered. ... Summit Medical Group, East Tennessee's largest primary care physician group, intends to pursue the establishment of an ACO. Summit is investing millions of dollars in systems, resources and infrastructure that its physicians believe will improve care coordination and result in an improved clinical outcome, improved patient experience and an improved financial outcome" (Harrington, 11/23).