Listen to lawyers and health policy experts with Powers Pyles Sutter & Verville summarize the critical changes to the ACO regulations and identify issues that should be considered by any organization considering an ACO. This webinar addressed the question — “Should I participate in an ACO now?”
THINGS YOU SHOULD KNOW IF YOU ARE CONSIDERING MEDICARE SHARED SAVINGS PROGRAMS
When CMS issued proposed regulations in April 2011 implementing the Medicare Shared Savings Program mandated by section 3022 of the Affordable Care Act, the program was widely criticized by the provider and practitioner communities. On October 20, 2011, CMS, the Office of Inspector General, and the Federal Trade Commission/Department of Justice all released regulations or other guidance on the Shared Savings Program, and the IRS followed suit shortly thereafter.
Did they get the risk/reward balance right? Are ACOs now fiscally attractive? Is the risk now manageable? Would your organization qualify for up front payments under the new CMS “Advance Payment Model”? What would qualifying as an ACO mean under the new antitrust enforcement policy? What new arrangements might be possible under the waiver of the physician self-referral and anti-kickback laws if you qualify as an ACO or take advantage of other reform measures? What are the risks and rewards of participating? Can you afford to participate or afford not to participate? What are the “known unknowns and the unknown unknowns” about ACOs?