Accountable Care Organizations (ACOs) play a prominent role as part of the Patient Protection and Affordable Care Act (PPACA). PPACA encourages the formation of ACOs by offering Medicare incentive payments to participating, qualifying ACOs through a program slated to begin on Jan. 1, 2012. Although currently there is only the potential for incentives to ACOs under the federal Medicare program, there has been much “buzz” over the eventual introduction of ACOs to the private sector.
PPACA only vaguely defines what constitutes an ACO, and much is yet left for interpretation. ACOs generally are designed to improve quality of patient care while at the same time curbing volume growth. CMS has not yet promulgated regulations on the topic. There has been much speculation as to how various ACOs will be structured and how they can be created so as not to run afoul of other laws and regulations, such as the federal antitrust laws.
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