Monthly Archives: May 2011

Questions Arise Regarding Provider Participation in ACOs

At a recent briefing on ACOs, sponsored by Alliance for Health Reform and The Commonwealth Fund, a senior CMS official acknowledged what many in the provider community have been grumbling since the ACO proposed rules were released in March that the ACO program, as currently projected, sets too high a bar for participation and provides insufficient rewards … Continue Reading

What you should know about the Innovation Center’s Pioneer ACO Model

By Sharon Bee Cheng, Strategic Healthcare The Center for Medicare and Medicaid Innovation (CMMI) recently unveiled the Pioneer Accountable Care Organization Model.  This program is intended to complement—not replace—the ACOs developed under the Shared Savings Program (SSP) authorized in Patient Protection and Affordable Care Act.  About thirty organizations will be chosen as Pioneer ACOs; letters of … Continue Reading

CMS Announces Four “Accelerated Development Sessions” to Teach Executives to Create Successful ACOs

Last Thursday, CMS announced four free “accelerated development sessions” (ADSs).  CMS describes the ADSs as “providing executives with the opportunity to learn about core functions of an Accountable Care Organization (ACO) and ways to build their organization’s capacity to succeed as an ACO. This 3-day, in-person ADS is to help new ACOs deliver better care … Continue Reading

When Forming ACOs, Plan For Disputes And Terminations

Many attorneys, commentators and consultants are recommending swift action for providers interested in participating in the Shared Savings Program through an Accountable Care Organization (“ACO”) because of the following: Primary care providers must be exclusive to one ACO; Applications for the first Shared Savings Program year, which starts on January 1, 2012, will likely be … Continue Reading

Are Racial/Ethnic Disparities Being Forgotten Among All of the Other Concerns in ACO Development?

Following the release of the ACO regulations by CMS and the concurrent release of guidance documents from the IRS, FTC, DOJ and OIG, much of the attention of the health care industry has been focused on the practical implementation of ACOs, tax considerations, fraud and abuse concerns, improved quality of care, and the potential for … Continue Reading

Looking Behind the Curtain at Structures and Capabilities of ACOs

By Sharon Bee Cheng, Strategic Healthcare I’m honored to be asked by the team at to offer some of our firm’s insight into what CMS is seeking in its regulations governing ACOs. CMS hopes that the formation of ACOs will prompt some reorganization of health systems, even the most integrated ones. Organizations that already substantially … Continue Reading

LiveBlog of FTC Workshop: Another Dose of Competition, Accountable Care Organizations and Antitrust

1:15PM—The workshop concluded a few minutes ago.  Overall, I suspect that most people present or who listened or viewed the webcast would agree that the discussion was helpful and certainly many excellent points were brought forward to the regulators.  Particularly in the second session, the regulators asked many probing questions, a good sign of their … Continue Reading

How do we develop ACOs that are designed to bring hospitals and physicians closer together while at the same time abide by laws designed to separate them?

Yesterday, the Centers for Medicare & Medicaid Services (CMS) presented an hour-long webinar on ACOs and Antitrust, Stark Law, Anti-Kickback Statute (AKS) and Civil Monetary Penalty Law (CMP), hosted by Troy Barsky, Director, Division of Technical Payment Policy and Michael Wroblewski, Performance-Based Policy Payment Staff for CMS. Troy Barsky addressed Stark, AKS and CMP laws.  … Continue Reading

SSD Health Practice Lawyer Offers Guidance to Hospital CEOs in Fierce Healthcare’s Hospital Insider

A tip of the hat to David Kopans, www.accountablecareforum blogger and Squire Sanders lawyer, for his post on Fierce Healthcare’s Hospital Insider titled:“Eight Things Hospital CEOs Should Know about The ACO Regulations.” David’s analysis has the #ACO Twitter community abuzz; and it’s great our bloggers are being recognized for analysis on ACO regulation impact on … Continue Reading

Upcoming CMS and FTC Public Forums Provide Opportunity to Comment on ACO Related Regulations

CMS is on the clock first, with a free webinar titled, “ACOs and Antitrust, Stark, Anti-Kickback, & Civil Monetary Penalty Law Webinar.”  Hosted by Troy Barsky, Director, Division of Technical Payment Policy at CMS and Michael Wroblewski, Performance-based Policy Payment Staff, the event is broken into two sessions this Thursday, May 5th, the first beginning … Continue Reading