Tag Archives: ACO

What Others are Saying: Media Round-Up on Final ACO Regs

This post has been contributed by Chase Matson, Manager, Government Relations, AMDR When we published last week’s blog post, Medicare ACO Rules Near Final Hurdle, we knew it would only be a matter of time before CMS released its final ACO regulations. Sure enough, only two days later, CMS officially published their long-anticipated rules, ending … Continue Reading

Webinar: Implications of the New ACO Regulations Announced for November 3

On Thursday, November 3rd, please join Squire, Sanders & Dempsey and Strategic Health Care for a complimentary webinar overview of the final rule recently released by the Centers for Medicare & Medicaid Services (CMS) and the opportunities it presents for Accountable Care Organizations (ACOs). As reported by the Accountable Care Forum, CMS made significant changes in … Continue Reading

CMS Releases MSSP/ACO Final Rule

On October 20, 2011, the Centers for Medicare and Medicaid Services (“CMS”) released the nearly 700-page, final rule for payments to health care providers and suppliers participating in accountable care organizations (“ACOs”) under the Medicare Shared Savings Program (“MSSP”).  In response to approximately 1,320 public comments to the proposed rule, the final rule makes a number … Continue Reading

AMA Comments Take Issue with ACO Regulations

The American Medical Association (AMA) recently issued its comments to CMS relating to the proposed Medicare Shared Savings Program ACO regulations.  The comments cover numerous areas of the proposed regulations, and overall, the AMA makes clear its concern that the program as currently proposed provides insufficient incentives for physician participation.  While acknowledging that the ACO … Continue Reading

Answers to a Few Frequently Asked ACO Questions

By Daniel J. Vukelich, AMDR Earlier this week, HealthLeaders Media addressed the Top 10 Clinical Integration, ACO Physician Questions.  Noting that physicians may be skeptical of new ACO arrangements, want to know how ACOs will impact their patients, and frankly how doctors will get compensated, the authors list the top ten most frequently asked questions about clinical integration (CI) and … Continue Reading

John Erikson Presents to Michigan Hospital Association

I recently co-presented a session regarding ACO’s with Tony Colarossi of Plante Moran.  We presented to the Michigan Hospital Association Excellence in Governance Fellows.  The audience consisted of hospital board members who participate in the fellowship program.  The board members were from hospitals large and small. The audience was keenly interested in the topic and … Continue Reading

Modern Healthcare turns to Squire Sanders Attorney as Expert Source on Proposed ACO Waiver Policy

We already know our John Kirsner as a frequent speaker and blogger regarding how CMS’ Accountable Care Organization regulations would impact health care delivery. Seeing Modern Healthcare’s Joe Carlson recognize him as such is further affirmation that Squire, Sanders, & Dempsey is building on its well deserved reputation as thought leaders in the future of … Continue Reading

Fierce Healthcare's Hospital Informer Profiles How Reprocessed Medical Devices Could Save Health Systems Billions

We love seeing our bloggers gain recognition.  Today, Dan Vukelich, blogger and President/CEO of the Association of Medical Device Reprocessors offers an insightful bylined news article that headlines today’s Hospital Informer, a Fierce Healthcare news outlet distributed to 15,000 hospital management subscribers.  The article offers an understanding of how the FDA-approved practice of third party reprocessing for certain … Continue Reading

Washington Post Reports on Results of Five Year Test of ACO-Like Incentives: Test Shows Innovation and Improved Care While Cost Savings Not as Significant as Hoped

The results from the five year “Group Practice Demonstration” project, which incentivized ten leading health systems if they could reduce costs by “treating older patients more efficiently while providing high-quality care,” were reported June 1 in the Washington Post. Although the article acknowledges that the test does not completely reflect the blueprint for ACOs eventually offered by CMS, … Continue Reading

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

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

Physicians Practice Interview on ACO Payments: Risk, Reward, and Reviewing Your Healthcare Partners

We’re getting some good traction in the hospital and physician trade press regarding our analysis of the ACO regs. I provided an interview with Physicians Practice discussing the shared savings models of the proposed rules for accountable care organizations and balancing risk versus reward in establishing new health care partnerships.  The interview centered on how the … Continue Reading

ACOs: Will High Start up Costs and Downside Risk Limit Interest in This Health Care Reform Darling?

Providers considering applying to CMS to become an ACO should be aware that the proposed ACO rules are modeled in significant part after Medicare’s Physician Group Practice demonstration project.  Five years in the planning and launched in April 2005, the PGP Demonstration included 10 multi-specialty group practices in various regions of the country comprised of … Continue Reading

Majority vs. Plurality Rule for Beneficiary Assignment

The Affordable Care Act requires the assignment of Medicare beneficiaries based on which physician provides a beneficiary’s primary care services, and delegates the task of prescribing the assignment methodology to the Secretary of Health and Human Services. After considering a majority rule and a plurality rule, CMS believes that the latter should be the governing … Continue Reading

Discord at the Agencies Regarding Antitrust Reviews?

As discussed previously here, here, and here, antitrust matters are a key consideration in the design of the Shared Savings Program and ACO development.  For example, antitrust review of prospective ACOs by the FTC and/or DOJ is a critical aspect of the ACO application process. Despite the release of the joint statement, there is evidence … Continue Reading