Tuesday, August 26, 2014

OMB Rejects CMS’ New ACO Regulation

James Michel

On Tuesday InsideHealthPolicy reported that the White House Office of Management and Budget (OMB) rejected CMS’ proposed rule on the second round of accountable care organization (ACO) contracts. Many health care analysts and policy makers have been awaiting publication of the new rule as anticipation and uncertainty around the ACO program builds. In 2011 CMS published the first set of rules governing ACOs’ participation in the Medicare Shared Savings Program and CMMI’s Pioneer ACO Demonstration, but that rule only covered ACOs’ first three-year contract period. Meanwhile, many ACOs, including all of the Pioneer ACOs, are approaching the end of their first contract period.

A recent survey by the National Association of ACOs showed that as many as two thirds of the current Medicare ACOs said they would likely drop out of the program if CMS didn’t make some drastic changes to existing rules. It is unclear what this means for ACOs in terms of continuing on in the program. It is also unclear which portions of the proposed regulation OMB asked CMS to redo or when the updated proposed rule should be expected.

AHCA will continue to follow developments in this story closely and provide updates as information becomes available. In the meantime, AHCA members are encouraged to review the ACO Contracting Guide, released to members last year, which contains a wealth of information and analysis of the current Medicare Shared Savings rules and a robust discussion around SNF-ACO contracting.

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