Under the new federal health reform law, groups of physicians who see Medicare patients and agree to work together – meeting certain government requirements to qualify as an ACO – would be eligible for bonuses if they meet spending benchmarks for caring for their patient population and other criteria.
Many in the health care industry see ACOs as an opportunity to capitalize on health reform, realign and boost overall cost effectiveness, but exactly how ACOs will work remains unclear, as the federal government still must spell out regulations.
Physicians need to make prudent decisions in the near future about their interest in participating, if they are to take advantage of the opportunities created by new health care reform laws and regulations.
CMA will continue to keep members apprised of all significant developments concerning ACOs and federal health care reform, as they unfold.
CMA Resources
ACO/Medical Foundation Principles: Physician-Hospital Alignment TAC Report as Adopted by CMA House of Delegates
ON-CALL Document: Legal and Practical Considerations Concerning Medical Foundations
An increasing number of California hospitals have reacted to the passage of health care reform by seeking to organize and operate so-called "1206(l) medical foundations." CMA is receiving an increasing number of questions from physicians concerning what these medical foundations are, and what considerations should influence their decision to join. This document is intended to provide a general overview of the legal and practical issues that present with "medical foundations.” (This document is free to members. Nonmembers can purchase this and other ON-CALL documents for $2/page from the CMA resource library.)
Webinar: Medical Foundations, Accountable Care Organizations and the Bundling of Services
In this webinar, Anthony Schiff, JD, MPH, Principal of Schiff and Bernstein, discusses the Health Care Reform Act that has spurred a new drive to “capture” physicians, consolidate practices and further integrate physicians and hospitals. This webinar deals with new models of practice by examining medical foundations and accountable care organizations (“ACOs”). The presentation will covers the bundling of physician services. Recorded June 15, 2010
In this powerpoint presentation, Francisco J. Silva, CMA's Vice President for Legal Affairs and General Counsel, outlines the requirements of the ACO and 1206(l) medical foundation laws and identifies risks and benefits that physicians should consider.
In this presentation, CMA CEO Dustin Corcoran examines the new drive by hospitals to "capture or align-with" physicians, integrate physicians and hospitals, and opportunities and risks of new health care payment and delivery reforms.
Letter to Members: A letter from CMA President J. Brennan Cassidy, M.D. (sent August 13, 2010)
Other Resources
- AMA Letter to CMS (AMA)
- Accountable Care Organizations: An Old Idea for New Times (Sg2 Health Care Intelligence)
- A National Strategy To Put Accountable Care Into Practice (Health Affairs)
- ACOs: Ten Questions You should Ask to Determine if You are Ready (Health Law Reporter)
- ACOs and HHS Regulations (Health Law Reporter)