On March 31, 2011, the Centers for Medicare & Medicaid Services (CMS) proposed guidelines for
doctors, hospitals, and other health care providers to establish Accountable Care Organizations (ACOs).
Health care experts hope that ACOs will put an end to fragmented care methods by creating a “shared savings program” to incentivize caregivers across all care settings to work together to provide high-quality,
coordinated care for Medicare beneficiaries. CMS has proposed the guidelines in advance of the program
becoming permanently established on January 1, 2012 in order to receive feedback from providers,
suppliers, Medicare beneficiaries and other interested members.
Theoretically, ACOs facilitate better care and bring down costs by establishing financial incentives for providers and suppliers (ie. physicians, hospitals, long-term care facilities) to monitor patients from start to finish. ACOs that make sure that patients receive appropriate care at the appropriate time and limit waste and abuse of procedures and tests will be eligible for additional Medicare payments. However, those who fail to meet the defined standards effectively could be held financially responsible for increasing costs in the health care system.
According to CMS, cost savings are not the sole goal of the program as ACOs would have to meet high quality standards measured by patient experience, care coordination, patient safety, preventive health, and at-risk population/frail elderly health to ensure that patients are “happy with the care they receive and have better health outcomes.”
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