Regulations Aim to Better Define Early Stages of Accountable Care Organizations

By Blume Forte Fried Zerres & Molinari on January 9, 2012

According to The New England Journal of Medicine (NEJM), the release of new regulations governing Medicare’s Accountable Care Organizations (ACO) provides an opportunity for the examination of this new healthcare model, which gives healthcare providers financial support to improve care in return for their acceptance of accountability for the overall cost and quality of that care. The final set of regulations, which were released in October 2011, aim to address various concerns which arose with the prior draft regulations.

According to the NEJM article, the final regulations make the following changes to Medicare’s ACO program:

  • Allow broader range of ACO governance structures;
  • Create more saving opportunities while delaying risk bearing;
  • Reduce the amount of required quality measures;
  • Allow for care from a greater variety of healthcare professionals, including specialists, to determine which ACO a patient is assigned to; and
  • Allow ACOs to identify and reach out to patients more effectively.

Although it is Medicare’s ACO program that seems to be garnering the most attention, there are, in fact, nearly 100 other provider organizations which govern themselves under the basic elements of the ACO model: tying payment to improvements in patient care and lowering overall spending growth. Coordinating for the benefit of improved patient care is one of the most important responsibilities of healthcare providers who are part of an ACO. The lack of and/or poor communication between healthcare providers concerning a patient’s health is often the basis of preventable medical errors that may seriously jeopardize the health and even life of the patient.

If you or a loved one has suffered further illness or injury as the result of a healthcare provider’s negligence, you may be entitled to financial compensation for your losses. To learn more about your legal rights and to determine whether your claim has merit, contact the experienced New Jersey medical malpractice attorneys at Blume Forte for a no-cost consultation at (973) 635-5400.

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