Academy Creates Summary to Help FPs Manage Information Overload on ACOs

After carefully reviewing the recently released final rule on Medicare Accountable Care Organizations, (189-page PDF; About PDFs) or ACOs, the AAFP has created a summary for members that winnows down the hundreds of pages in the rule to a 19-page version that provides a brief, but comprehensive, overview of the segments of the rule that could affect them.

The AAFP summary, "Medicare Shared Savings Program: Accountable Care Organizations Final Rule," (19-page PDF; About PDFs) is divided into 12 headings that cover information on such topics as historical background, ACO eligibility, structure and governance, shared savings methodology, quality measures, and the advanced payment model.

The summary also offers links to additional online materials, including eight tables that explain payment details, such as creation and use of quality performance standards for ACOs, a shared savings program overview, and the proposed minimum savings rate based on the number of assigned beneficiaries.

The summary also explains that the final rule looks very different from the proposed rule because it incorporates a number of changes suggested by the AAFP. For example, CMS accepted Academy recommendations to

Participation in ACOs and Medicare shared savings programs is voluntary, but the Patient Protection and Affordable Care Act, which promulgates the ACO model, states that individual ACOs must include enough primary care professionals to care for the Medicare beneficiaries assigned to that ACO. In addition, an ACO must have an assignment of at least 5,000 Medicare beneficiaries, so the formation of any ACO is highly dependent on primary care professionals.

According to a statement by AAFP President Glen Stream, M.D., M.B.I., of Spokane, Wash., "The Medicare Accountable Care Organization final rule recently released by CMS represents a substantial step toward mending America's broken health care system. The final rule sets the stage for transforming the way patients receive care and promises to end the fragmentation, duplication and miscommunication that contribute to poor care and high costs."