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Medicare program; Medicare Shared Savings Program: Accountable Care Organizations. Final rule.

Federal Register

|November 4, 2011

Summary

This rule details Medicare payments for Accountable Care Organizations (ACOs) in the Shared Savings Program. Providers can receive fee-for-service payments and earn bonuses for meeting quality and savings goals.

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Area of Science:

Healthcare Policy
Health Economics

Background:

The Affordable Care Act introduced Accountable Care Organizations (ACOs) to improve healthcare quality and reduce costs.
The Medicare Shared Savings Program (MSSP) is a key initiative for ACO development.

Purpose of the Study:

To outline the final rule implementing Section 3022 of the Affordable Care Act.
To define Medicare payment structures for providers participating in ACOs under the MSSP.

Main Methods:

Implementation of Section 3022 of the Affordable Care Act.
Establishment of payment rules for ACO participants.

Main Results:

Providers can continue receiving traditional Medicare fee-for-service (FFS) payments.
Eligibility for additional payments is contingent upon meeting quality and savings requirements.

Conclusions:

The final rule facilitates provider participation in ACOs by clarifying payment mechanisms.
The program incentivizes quality improvement and cost savings within the Medicare system.