Accountable Care Organizations

On March 31st the Obama administration issued the draft regulations for Medicare Accountable Care Organizations (ACOs).

ACOs are to eventually be the centerpiece of cost savings for the entire US health care system. This is the first peak at how the ACOs might be defined.

In the "they never learn" category, the draft regulations are 429 pages long.

http://www.ofr.gov/OFRUpload/OFRData/2011-07880_PI.pdf

Some thoughts on the draft regulations:

1. The sections delineating what an ACO should accomplish and how to do it are well formed and should be adoptable without much change. Whether these ambitious goals are attainable is a major question and concern.

2. The feds are not certain who should participate in the first round of Medicare ACOs and have laid out many options that will require a great deal of comment and time to sort out. I suspect the more limited options (physician and physician-extender providers and hospitals) will be used for the first round.

It is likely the final regs will not be published until fall, and these ACOs are supposed to be operating January 1, 2012. This is a tight timeline.