Nudging doctors and hospitals toward working together to bring down health care costs, the Obama administration has released long-awaited rules on how groups of providers can receive Medicare patients under a popular new model of care.
The Center for Medicare and Medicaid Services modified the rules to make it easier for doctors and hospitals to participate in Accountable Care Organizations (ACOs), after soliciting comments six months ago.
A major focus in President Obama’s health care law, ACOs are viewed as an antedote to curb rapid health care inflation by offering an integrated care network. They’re a trending topic in the health community, with California-based ACOs like Kaiser Permanente and HealthCare Partners demonstrating care that maintains quality but costs less.
The health care law allows Medicare to contract with ACOs for the first time. They are composed of a group of providers who share in one payment for providing a patient with a spectrum of care, motivating them to communicate with each other and keep costs down.
To encourage more providers to form or join ACOs, the administration is providing incentives like partially reimbursing providers if they achieve savings in caring for Medicare patients. The new rules also provide more subsidies for physician-led groups and rural providers who have fewer resources to start an ACO.
“It means that when you go home from the hospital, your help doesn’t stop,” said Don Berwick, administrator for CMS. “It means that every single one of the physicians on your team knows who you are, knows what you want and know what you need. That great, coordinated care hasn’t always been the kind of care Medicare has encouraged.”