Here Blair Childs, a senior vice president for Premier Inc., who has met with officials drafting the regulations, explains several concerns he hopes they will address. Premier is leading a collaborative of 19 health systems committed to launching ACOs.
1. How will patients be assigned? Do they have to agree to sign up or will they be allocated? Each ACO needs to have at least 5,000 patients.
2. How will savings be calculated? Savings will be based on healthcare spending trends, allowing for a margin or error, called a buffer zone, that CMS will not include in the savings. What will be the size of that buffer zone?
3. How will savings be shared? Savings will be disbursed among many independent providers, so some form of disbursement mechanism will be essential.
4. Who runs the ACO? The law makes it clear that hospitals or physician groups can run ACOs, but it is possible that other entities could run them. In addition, the regulations also have to clarify many details of operation and governance.
5. What measures will be used? The law does not state what measures will be used for quality and cost reduction.
6. Clearing up legal issues. When independent providers share payments in an ACO, antitrust and Stark issues have to be addressed.
Learn about the Premier Accountable Care Collaborative.
