HHS Issues Accountable Care Guidelines

April 1, 2011 – In The News
Pittsburgh Business Times

On March 31, the U.S. Department of Health and Human Services outlined new guidelines that will alter the model for delivering care to large groups of Medicare beneficiaries. The guidelines support the federal government’s first outline of what accountable care organizations will be, a concept promoted in federal health care reform legislation. In the new model, health care providers will be responsible for the cost and quality of care but also rewarded for reducing unnecessary expenditures.

William H. Maruca said a ban on physician self-referrals and anti-kickback statutes may be hurdles for hospital networks that set up accountable care organizations. “Everybody is going to want to hang their ACO sign on the door,” he said. “The bigger the panel of employed physicians, the fewer antitrust problems you will have. That has been driving the push to employ physicians over the past year or two.”

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