Becker’s Hospital Review - The Top 10 Healthcare Leaders Share Thoughts on the Final ACO Rule

Written by Bob Herman, October 21, 2011

The healthcare industry has been a buzz since the Department of Health and Human Services released its final rule for the Medicare Shared Savings Program yesterday. Several changes have been made from the proposed rule. Quality measurements were reduced from 65 to 33, and other proposed requirements were relaxed. Here are 10 healthcare leaders' thoughts on the ACO final rule and what it could mean for the future of ACO adoption.

By Daniel Marino, President and CEO of Health Directions: There are three significant areas that will positively affect organizations: care coordination, requirements around meaningful use and reliance on electronic health technology. The most significant changes in the final ACO regulations are around the measures for establishing quality performance-scoring. The measures that were retained support care coordination around chronic disease management and prevention. More specifically, the final regulations remove the complicated care coordination measures relating to complications of chronic disease. These changes will allow organizations that are just beginning to build clinical integration a better opportunity to succeed under the shared savings model.

The second area of opportunity comes in the way of requirements around MU. The final regulations speak to MU compliance and providing a benefit, through a higher allocated score, to organizations who have more of their primary care providers MU-compliant. There is no longer a minimum percentage of providers that must be meaningful users. Instead, ACOs that have high percentages of meaningful users have an opportunity to achieve higher quality scores via a new, weighted scoring method.

The third area of opportunity is around the relaxed reliance on integrated health technology to support the ACO. The final regulations limit the requirement around advanced care coordination across the patient's care continuum. Initially, this was a major concern of many organizations since creating an advanced integrated technical infrastructure was very expensive, and in some cases cost prohibitive to organizations. This less prescriptive approach will allow ACOs more flexibility and room for innovation. The final regulations appear to create a nice balance between driving care coordination around patient quality outcomes to reduce costs and not overburdening organizations with significant new infrastructure investments and cumbersome reporting requirements.