The document, called “Preliminary Questions and Answers on Accountable Care Organizations,” provides answers such as stating what attributes groups must have to be designated Medicare ACOs.
Those attributes are:
1) A formal legal structure to receive and distribute shared savings.
2) Have “a sufficient number” of primary care professionals to treat at least 5,000 assigned Medicare beneficiaries.
3) Participate in the program for at least 3 years.
4) Sufficient information on its health care professionals “to support beneficiary assignment and for the determination of payments for shared savings.”
5) A leadership and management structure.
6) Have defined processes for evidenced-based medicine, data-reporting and coordination of care.
7) Meet “patient-centeredness criteria,” to be determined by the government.
CMS expects to publish more details on ACOs in a Notice of Proposed Rulemaking this fall.
Read CMS’ document on accountable care organizations (pdf).
